Individual
BETHANY SHELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
800 FLORIDA AVE NE # 1844, WASHINGTON, DC 20002-3600
(317) 581-0565
Mailing address
800 FLORIDA AVE NE # 1844, WASHINGTON, DC 20002-3600
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
03/01/2012
Last updated
03/01/2012
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