Individual
LACY JANE BEBOUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7905 N MEADOWLARK WAY, COEUR D ALENE, ID 83815-5041
(208) 618-2709
Mailing address
1559 W TUALATIN DR, POST FALLS, ID 83854-5186
(208) 786-0676
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/03/2025
Last updated
10/03/2025
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