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Individual

MS. BETHANY LOREN O'MALLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
10015 OLD COLUMBIA ROAD, SUITE B215, COLUMBIA, MD 21046
(443) 800-4985
Mailing address
3717 BOSTON ST # 148, BALTIMORE, MD 21224-5752
(443) 800-4985

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
08/17/2020
Last updated
08/17/2020
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