Individual
MORRIS MICHEL BENTLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
365 CENTER ROAD, GRANGEVILLE, ID 83530-0145
(208) 983-5535
(208) 983-5575
Mailing address
PO BOX 145, GRANGEVILLE, ID 83530-0145
(208) 983-5535
(208) 983-5575
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1190
ID
Other
Enumeration date
11/27/2006
Last updated
07/08/2007
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