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1114356847
BETHANY EISEN
RICHMOND, MI
NPI
1114356847
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: MI E250085603037)
Enumeration Date
2013-11-04
Last Update Date
2013-11-04
Business Address
-- BETHANY EISEN
400 STODDARD RD
RICHMOND, MI 48062-2505
Phone number: 810-392-2167
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Mailing Address
-- BETHANY EISEN
1450 RIVER RD UNIT 17
SAINT CLAIR, MI 48079-2809
Phone number:
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