Individual
MRS. BETHANY ROSE IRVINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
5638 PROFESSIONAL CIR, INDIANAPOLIS, IN 46241-5042
(317) 247-8900
(317) 247-8935
Mailing address
5638 PROFESSIONAL CIR, INDIANAPOLIS, IN 46241-5042
(317) 247-8900
(317) 247-8935
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34006818A
IN
Other
Enumeration date
09/05/2008
Last updated
12/20/2013
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