| NPI | 1174627681 |
|---|---|
| Former Name | BETHANY JOEL STOCKHOLM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 35.088279) |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2018-03-17 |