Individual
BETHANY SAMMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
5010 N STONE MILL RD, BLOOMINGTON, IN 47408-9320
(812) 929-2193
(888) 789-8394
Mailing address
5010 N STONE MILL RD, BLOOMINGTON, IN 47408-9320
(812) 929-2193
(888) 789-8394
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
33009097A
IN
Other
Enumeration date
10/04/2019
Last updated
10/04/2019
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