Individual
MICHAEL S BEZAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
722 CHENEY DR, TWIN FALLS, ID 83301-3472
(208) 320-1108
(208) 735-1890
Mailing address
722 CHENEY DR, TWIN FALLS, ID 83301-3472
(208) 320-1108
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC-4680
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LPC-4680
LICENSED PROFESSIONAL COUNSELOR
ID
Enumeration date
06/12/2013
Last updated
06/12/2013
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