Individual
BETHANY J WALLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OCCUPATIONAL THERAPI
Contact information
Practice address
6500 THAYER CTR, OAKLAND, MD 21550-1116
(301) 334-1863
(301) 334-5835
Mailing address
RR 2 BOX 396, ALBRIGHT, WV 26519-9768
(304) 379-6577
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
05259
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0009
FEDERAL BCBS
MH
01
—
6157478
CIGNA
MD
01
—
61968501
CAREFIRST BCBS
MD
05
—
7502154000
—
WV
Enumeration date
09/21/2006
Last updated
07/09/2007
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