Individual
MS. BETHANY D'AUN WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
184 UNSER BLVD NE, RIO RANCHO, NM 87124-4045
(505) 896-0928
Mailing address
184 UNSER BLVD NE, RIO RANCHO, NM 87124-4045
(505) 896-0928
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
CMF0218751
NM
106H00000X
Marriage & Family Therapist
LF60309365
WA
106H00000X
Marriage & Family Therapist
T0795
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2091942
—
WA
Enumeration date
12/29/2008
Last updated
07/29/2021
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