Individual
TALYSA S BETHEA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
137 N ERWIN ST, CARTERSVILLE, GA 30120-3123
(770) 334-3708
Mailing address
1300 N BROAD ST NE APT B, ROME, GA 30161-5267
(910) 723-9982
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
09/11/2023
Last updated
09/11/2023
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