Individual
BETHEL MICHAEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
789 JUSTIN RD, ROCKWALL, TX 75087-4840
(972) 771-5731
Mailing address
3005 KINGSBROOK DR, WYLIE, TX 75098-8529
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
124492
TX
Other
Enumeration date
09/08/2025
Last updated
09/10/2025
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