Individual
EVAN BOTHMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSW
Contact information
Practice address
910 KENTON STATION DR, MAYSVILLE, KY 41056-9613
(606) 759-0433
Mailing address
611 FOREST AVE, MAYSVILLE, KY 41056-1411
(606) 564-4016
(606) 564-0295
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
254612
KY
Other
Enumeration date
01/09/2015
Last updated
12/13/2022
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