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1033121520
LARRY KIRK HAZEN
TWIN FALLS, ID
NPI
1033121520
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: ID LCSW-26947)
Enumeration Date
2006-08-12
Last Update Date
2007-07-08
Business Address
-- LARRY KIRK HAZEN LCSW
260 2ND AVE E
TWIN FALLS, ID 83301-6242
Phone number: 208-732-0947
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Mailing Address
-- LARRY KIRK HAZEN LCSW
1887 RIVERWOOD RD
TWIN FALLS, ID 83301-3084
Phone number: 208-733-3730
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