Individual
MICHELLE MARIE BAZAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
200 HIGHWAY 2 W, DEVILS LAKE, ND 58301-3532
(701) 665-2200
(701) 665-2300
Mailing address
CO LAKE REGION HUMAN SERVICE CENTER, 200 HWY 2 WEST, DEVILS LAKE, ND 58301-3532
(701) 665-2200
(701) 665-2300
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1848
ND
171M00000X
Case Manager/Care Coordinator
1848
ND
Other
Enumeration date
03/07/2019
Last updated
12/13/2024
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