Individual
BETHEL VERCRUYSSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1325 APPALOOSA CT, AUBURN, CA 95603-5863
(916) 206-9563
Mailing address
PO BOX 15, ROSEVILLE, CA 95661-0015
(916) 206-9563
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
ASW 35906
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ASW 35906
CLINICAL SOCIAL WORKER
CA
Enumeration date
11/01/2013
Last updated
11/01/2013
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