Individual
TAMALA TERRAL BETHEA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
525 E GAY ST, WEST CHESTER, PA 19380-2718
(484) 597-4091
Mailing address
2024 W 9TH ST, CHESTER, PA 19013-2605
(484) 597-2409
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
49143601
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
83-3838714
2
PA
Enumeration date
01/14/2022
Last updated
01/14/2022
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