Individual
BETHANNE PACKARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4445 BURNS AVE, LOS ANGELES, CA 90029-2702
(323) 222-1440
Mailing address
4445 BURNS AVE, LOS ANGELES, CA 90029-2702
(323) 222-1440
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
04/16/2024
Last updated
04/16/2024
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