Provider Demographics
NPI:1942596598
Name:BAZER, PATRICE L (MSW)
Entity Type:Individual
Prefix:MS
First Name:PATRICE
Middle Name:L
Last Name:BAZER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3085 INDIANA AVE
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82609-1845
Mailing Address - Country:US
Mailing Address - Phone:954-232-7059
Mailing Address - Fax:
Practice Address - Street 1:3085 INDIANA AVE
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82609-1845
Practice Address - Country:US
Practice Address - Phone:954-232-7059
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-22
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY8231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical