Individual
BETHANY DARLENE SIMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
633 BAXTER AVE, LOUISVILLE, KY 40204-1157
(502) 309-2408
(502) 771-4283
Mailing address
633 BAXTER AVE, LOUISVILLE, KY 40204-1157
(502) 309-2408
(502) 771-4283
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
162423
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100310790
—
KY
Enumeration date
09/25/2013
Last updated
10/14/2022
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