Individual
BETHANY TENNANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CRC, LPCA
Contact information
Practice address
1104 CHERYL LN, WILMINGTON, NC 28405-1253
(304) 238-3673
Mailing address
1104 CHERYL LN, WILMINGTON, NC 28405-1253
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
A14507
NC
101YP2500X
Professional Counselor
Primary
A14507
NC
Other
Enumeration date
04/20/2019
Last updated
04/20/2019
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