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1043753742
LARRY BEARDEN
LEWISTON, ID
NPI
1043753742
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: ID LCPC-4986)
Enumeration Date
2016-11-29
Last Update Date
2016-11-29
Business Address
Mr. LARRY BEARDEN M.S.
428 6TH AVE
LEWISTON, ID 83501-2355
Phone number: 208-799-6500
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Mailing Address
Mr. LARRY BEARDEN M.S.
428 6TH AVE
LEWISTON, ID 83501-2355
Phone number: 208-799-6500
Copy
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