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Individual
BETHANY VANNE
Active
Individual
BETHANY VANNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.C.P.C.
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
180.008327
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1245454313
NPI - GROUP - JOHN R. DAY AND ASSOCIATES
IL
01
—
366380
MEDICARE, PTAN
IL
01
—
371154942
TEIN - TAX IDENTIFICATION NUMBER FOR EMPLOYER
IL
Enumeration date
08/13/2012
Last updated
08/14/2012
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