Individual
BETHANY ANN EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
34 LAUREL RD # 1, MILTON, MA 02186-1522
(617) 943-3813
Mailing address
34 LAUREL RD # 1, MILTON, MA 02186-1522
(617) 943-3813
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
221666
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
221666
BOARD OF SOCIAL WORK
MA
05
—
221666
—
MA
Enumeration date
10/08/2020
Last updated
10/08/2020
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