Individual
BETHANY MARIE MCMILLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
1310 NW DEANE ST, PULLMAN, WA 99163-3705
(509) 332-1566
Mailing address
230 SUMMIT RIDGE PL, WELDON SPRING, MO 63304-0907
(636) 699-5548
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2018030897
MO
225X00000X
Occupational Therapist
60920416
WA
Other
Enumeration date
04/30/2019
Last updated
04/30/2019
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