Individual
BETHANY KITTLE BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4409 DOBIE RD, OKEMOS, MI 48864-2900
(517) 505-6499
Mailing address
PO BOX 1618, WRANGELL, AK 99929-1618
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
MI
Other
Enumeration date
07/19/2007
Last updated
12/04/2023
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