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Individual

ANGELA R BETHEA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
315 WEST PONCE DE LEON AVENUE, SUITE 350, DECATUR, GA 30030-2490
(404) 373-2220
(404) 373-9337
Mailing address
315 WEST PONCE DE LEON AVENUE, SUITE 350, DECATUR, GA 30030-2490
(404) 373-2220
(404) 373-9337

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY003270
GA

Other

Enumeration date
01/08/2010
Last updated
01/08/2010
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