Individual
DR. WANDA LOUISE BETHEA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
405 E STRAWBRIDGE AVE, MELBOURNE, FL 32901-4558
(321) 724-6177
Mailing address
265 LAGO CIR, APT. #302, WEST MELBOURNE, FL 32904-3383
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY4731
FL
Other
Enumeration date
05/18/2007
Last updated
07/16/2010
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