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Individual

BETHANY ROSE LEE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA, LADC

Contact information

Practice address
11505 36TH AVE N, PLYMOUTH, MN 55441-2304
(763) 509-3838
Mailing address
15330 18TH AVE N APT 907, PLYMOUTH, MN 55447-2468
(320) 221-5686

Taxonomy

Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
MN

Other

Enumeration date
12/31/2025
Last updated
12/31/2025
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