Doctor Name: | BETHANY BLANKENSHIP |
NPI Number: | 1013385459 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 268 |
Business Practice Address: | 1215a Stewart Plz Dunbar, WV - 250643021 |
Business Phone Number: | 3047685506 |
Business Fax Number: | |
Mailing Address: | 1215a Stewart Plz, DUNBAR |
State: | WV |
Postal Code: | 250643021 |
Phone Number: | 3047685506 |
Fax Number: | |
NPI Enumeration Date: | 09/02/2015 |
NPI Last Update Date: | 09/02/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 268 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WV |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |