Individual
BETHANY KATE WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
35 N MAIN ST, SOUTHINGTON, CT 06489-2577
(860) 378-9659
Mailing address
50 LAGANA AVE, PLANTSVILLE, CT 06479
(860) 378-9659
Taxonomy
Speciality
Code
Description
License number
State
374J00000X
Doula
Primary
—
—
Other
Enumeration date
01/01/2025
Last updated
01/01/2025
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