| 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 |