Individual
BETHANY CELESTE HALLIWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
3117 BROADWAY APT 49, NEW YORK, NY 10027-4658
(610) 507-8649
Mailing address
3117 BROADWAY APT 49, NEW YORK, NY 10027-4658
(610) 507-8649
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
025732
NY
Other
Enumeration date
06/13/2021
Last updated
06/13/2021
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