Most Relevant Information
Provider Data
| NPI Number: | 1003031287 |
| Provider Name: | TINA LORRAINE BEZONA LPC |
| Entity Type: | Individual |
| Taxonomy Code: | 101YP2500X |
| Specialty: | Counselor |
| License Number: | 4266 |
Most Important Dates
| Enumeration Date: | 04/14/2007 |
| Last Updated: | 01/19/2024 |
Provider Practice Location
107 S 9TH ST
CANON CITY
CO
812123800
Practice Location Phone/Fax
| Phone: | 7194305929 |
| Fax: |
Provider Mailing Location
1183 S CAMINO SANTIAGO DR
PUEBLO WEST
CO
810071904
Provider Mailing Phone/Fax
| Phone: | 7196519301 |
| Fax: | 7195478171 |