Individual
BOBBY BEQUETTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
125 COMMERCE ST STE B, MCCALL, ID 83638-5192
(208) 861-9157
Mailing address
PO BOX 391, CASCADE, ID 83611-0391
(208) 861-9157
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6386
ID
Other
Enumeration date
03/14/2017
Last updated
03/14/2017
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