| NPI | 1861232688 |
|---|---|
| Former Name | BETHANY MILLER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL APRN11039098) |
| Enumeration Date | 2024-05-29 |
| Last Update Date | 2025-05-22 |