Individual
BETHANY BASINGER COBURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1627 OAK AVE STE C, DAVIS, CA 95616-1072
(773) 678-9975
Mailing address
2114 POLLOCK CT, DAVIS, CA 95618-7620
(773) 678-9975
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
61298
CA
Other
Enumeration date
05/30/2019
Last updated
05/30/2019
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