| NPI | 1619115201 |
|---|---|
| Former Name | BETHANY MICHELE GODWIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TN 4002) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2009-02-04 |
| Last Update Date | 2023-05-22 |