Individual
MS. BETHANN WISE DETWILER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., L.P.C.
Contact information
Practice address
5352 TWIN HICKORY RD, GLEN ALLEN, VA 23059-5682
(804) 592-2793
(804) 592-2794
Mailing address
5352 TWIN HICKORY RD, GLEN ALLEN, VA 23059-5682
(804) 592-2793
(804) 592-2794
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701005427
VA
Other
Enumeration date
03/17/2013
Last updated
03/17/2013
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