Individual
BETHANY PATRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1305 W MAGNOLIA AVE STE A, FORT WORTH, TX 76104-4345
(817) 601-9736
Mailing address
1305 W MAGNOLIA AVE STE A, FORT WORTH, TX 76104-4345
(817) 601-9736
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-17-44704
TX
Other
Enumeration date
01/18/2022
Last updated
01/18/2022
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