Individual
CARSON J BEDKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
4319 W ROSE HILL CT, BOISE, ID 83705-1361
(208) 681-4186
Mailing address
4319 W ROSE HILL CT, BOISE, ID 83705-1361
(208) 681-4186
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
5624
ID
Other
Enumeration date
11/10/2014
Last updated
11/10/2014
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