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Individual

CRYSTAL NICHOLE BETHEA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
SOCIAL WORKER

Contact information

Practice address
100 EMANCIPATION DR, HAMPTON, VA 23667-0001
(757) 532-9051
Mailing address
17 MELBORNE PL, HAMPTON, VA 23669-4231
(757) 532-9051

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
0903003093
VA
1041C0700X
Clinical Social Worker
Primary
13905
SC

Other

Enumeration date
01/04/2021
Last updated
01/04/2021
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