| NPI | 1316252661 |
|---|---|
| Former Name | BETHANY RAE LEWIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OR L7348) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: OK 5696) |
| Enumeration Date | 2010-08-11 |
| Last Update Date | 2021-12-21 |