| Doctor Name: | BETHANY S COLAPRETE |
| NPI Number: | 1174864052 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.ED, LPC |
| License Number: | LPC-5059 |
| Business Practice Address: | 212 Rodeo Dr Suite 410 Moscow, ID - 838439798 |
| Business Phone Number: | 2088825960 |
| Business Fax Number: | |
| Mailing Address: | 1984 Brown Rd, LENORE |
| State: | ID |
| Postal Code: | 835415095 |
| Phone Number: | 2084319119 |
| Fax Number: | |
| NPI Enumeration Date: | 03/03/2013 |
| NPI Last Update Date: | 03/03/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | LPC-5059 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ID |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |