Individual
MRS. BETHANY JANE DECOLLIBUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. LMFT
Contact information
Practice address
182 SUMMER ST # 226, KINGSTON, MA 02364-1277
(781) 312-8779
Mailing address
182 SUMMER ST # 226, KINGSTON, MA 02364-1277
(781) 312-8779
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
1678
MA
106H00000X
Marriage & Family Therapist
MFT00169
RI
Other
Enumeration date
08/05/2015
Last updated
03/15/2021
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