Individual
MAUREEN SMITH BETHEA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
10640 PAGE AVE STE 210, FAIRFAX, VA 22030-4000
(704) 614-2388
Mailing address
10640 PAGE AVE STE 210, FAIRFAX, VA 22030-4000
(703) 744-0609
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
0717001248
VA
Other
Enumeration date
07/26/2012
Last updated
10/20/2020
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