Individual
BETHANY CARTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
526 OLD LIVERPOOL RD, LIVERPOOL, NY 13088-6238
(315) 453-3911
(315) 453-0197
Mailing address
PO BOX 417153, BOSTON, MA 02241-7153
(518) 952-8140
(518) 952-8287
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
647333
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03008275
—
NY
Enumeration date
03/25/2013
Last updated
03/25/2013
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