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General NPI Number Information
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NPI Number | 1861285181
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Entity Type | Individual
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Provider Name | LAURA MARIE BEAZER LMSW
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Gender | Female
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Dates
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Enumeration Date | 05/28/2025
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Last Update Date | 07/28/2025
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Provider Practice Location Address
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Address Line | 6807 CODY ST
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City | BONNERS FERRY
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State | ID
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Zip | 83805-8613
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Country | US
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Telephone | 208-267-0900
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Fax |
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Provider Business Mailing Address
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Address Line | 93 FLICKER RD
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City | MOYIE SPRINGS
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State | ID
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Zip | 83845-5039
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Country | US
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Telephone | 208-610-6036
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 9171067
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License Number State | ID
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