Individual
BETHANY ANN DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LPC, NCC
Contact information
Practice address
2577 NE COURTNEY DR, BEND, OR 97701-7638
(541) 322-7500
Mailing address
2577 NE COURTNEY DR, BEND, OR 97701-7638
(541) 322-7500
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
C5250
OR
Other
Enumeration date
01/19/2012
Last updated
03/05/2020
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