Individual
MRS. TIMEICA E BETHEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
47 W POLK ST STE 100-240, CHICAGO, IL 60605-2000
(872) 903-0461
Mailing address
47 W POLK ST STE 100-240, CHICAGO, IL 60605-2000
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
171M00000X
Case Manager/Care Coordinator
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
09/14/2020
Last updated
09/14/2020
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