Individual
BETHANY FEGADEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2151 DILLARD XING, TUCKER, GA 30084-5937
(585) 739-6266
Mailing address
2151 DILLARD XING, TUCKER, GA 30084-5937
(585) 739-6266
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
1041C0700X
Clinical Social Worker
LC23567
ME
Other
Enumeration date
12/04/2020
Last updated
05/28/2025
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