Individual
MS. BETHANY DABORAH WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15 WINTHROP ST, BROCKTON, MA 02301-5221
(774) 444-7904
Mailing address
7108 S KANNER HWY, STUART, FL 34997-7462
(855) 832-6727
(722) 675-9100
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
MA
Other
Enumeration date
01/26/2024
Last updated
01/27/2024
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