Individual
MS. ETHEL BETHEA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
121 ROSETTE ST, NEW HAVEN, CT 06519-2427
(203) 214-7584
Mailing address
121 ROSETTE ST, NEW HAVEN, CT 06519-2427
(203) 214-7584
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
000836
CT
Other
Enumeration date
05/24/2011
Last updated
05/24/2011
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