Individual
BETHANY LORA CHASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
60 MACDOUGAL ST, NEW YORK, NY 10012-2920
(212) 477-1297
Mailing address
60 MACDOUGAL ST, NEW YORK, NY 10012-2920
(212) 477-1297
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
72 072116
NY
Other
Enumeration date
10/15/2009
Last updated
10/15/2009
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