Individual
BETHANY VANEMBURGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
81 PLANTATION ST, WORCESTER, MA 01604-3069
(508) 849-5600
Mailing address
81 PLANTATION ST, WORCESTER, MA 01604-3069
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
2358
MA
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
222873
MA
Other
Enumeration date
10/09/2013
Last updated
07/23/2019
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