Individual
DARLA K. BETHKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SP
Contact information
Practice address
1301 W PROVIDENCE AVE, ORANGE, CA 92868-3808
(714) 639-4990
Mailing address
22706 ISLAMARE LN, LAKE FOREST, CA 92630-3634
(949) 859-8158
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP5328
CA
261Q00000X
Clinic/Center
956154473
CA
Other
Enumeration date
03/20/2013
Last updated
03/20/2013
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