Individual
LAKERA YANEE BETHEA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2709 WILD POPLAR WAY, GREENSBORO, NC 27405-2970
(910) 373-1219
Mailing address
2709 WILD POPLAR WAY, GREENSBORO, NC 27405-2970
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
—
NC
251C00000X
Developmentally Disabled Services Day Training Agency
—
NC
252Y00000X
Early Intervention Provider Agency
Primary
—
NC
Other
Enumeration date
05/11/2016
Last updated
05/11/2016
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