Individual
MRS. BETHANY A HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
TLLP
Contact information
Practice address
6060 DIXIE HWY STE H, CLARKSTON, MI 48346-3476
(248) 270-5395
Mailing address
730 S DAYTON ST, DAVISON, MI 48423-1716
(810) 333-3860
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6362009122
MI
Other
Enumeration date
10/03/2020
Last updated
10/03/2020
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