Provider Information for 1689069460
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STEVE M. BEZDEKA LCPC
Sex: Male
NPI: 1689069460
Last Updated: 2025-02-28
Certification Date: 2025-02-28
Certification Date: 2025-02-28
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1689069460 | ||||||||
| Enumeration Date | 2015-03-30 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | PO BOX 886 HAILEY, ID 83333-0841 United States Phone: 208-233-3456 | Fax: | ||||||||
| Primary Practice Address | 314 S. RIVER STREET HAILEY, ID 83333-0841 United States Phone: 208-233-3456 | Fax: | ||||||||
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