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Individual

MS. TERESA K BELNAP-HAZEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
445 W CHUBBUCK RD STE C, CHUBBUCK, ID 83202-5069
(208) 237-0385
(208) 237-0385
Mailing address
PO BOX 5518, CHUBBUCK, ID 83202-0004
(208) 237-0385
(208) 237-0385

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-28387
ID

Other

Enumeration date
11/01/2009
Last updated
11/01/2009
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