Individual
BETHANY ROSE MINK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT, PSYD
Contact information
Practice address
4060 FAIRMOUNT AVE, SAN DIEGO, CA 92105-1608
(619) 606-0296
Mailing address
1045 9TH AVE, SAN DIEGO, CA 92101-5504
(248) 830-0303
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
30519
CA
106H00000X
Marriage & Family Therapist
79616
CA
Other
Enumeration date
10/29/2010
Last updated
03/08/2019
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