NPI | 1740581917 |
---|---|
Former Name | BETHANY DAWN BATES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 71356) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 9228) |
Enumeration Date | 2010-11-04 |
Last Update Date | 2023-08-02 |