Individual
BETHANY L GRAVELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
324 T B STANLEY HWY STE BANDC, BASSETT, VA 24055-6108
(276) 638-0787
(276) 629-2695
Mailing address
324 T B STANLEY HWY STE BANDC, BASSETT, VA 24055-6108
(276) 638-0787
(276) 629-2695
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904010393
VA
1041C0700X
Clinical Social Worker
DP00945274
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1093891335
—
VA
01
—
36-4567127
LIFE STRATEGIES
WV
Enumeration date
03/06/2018
Last updated
11/11/2024
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