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Individual
LATASHA BETHEA
Active
Individual
LATASHA BETHEA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, P-LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
P004212
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3403400
—
NC
01
—
562033116
TRICARE
—
Enumeration date
04/09/2008
Last updated
04/09/2008
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