Doctor Name: | MRS. BETHANY LORNA MCLEMORE |
NPI Number: | 1023045630 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | 0701003259 |
Business Practice Address: | 3433 Brambleton Ave Suite 117b Roanoke, VA - 240186515 |
Business Phone Number: | 5407258824 |
Business Fax Number: | 5407258826 |
Mailing Address: | 6907 Mason Knob Trl, ROANOKE |
State: | VA |
Postal Code: | 240186937 |
Phone Number: | 5407763153 |
Fax Number: | |
NPI Enumeration Date: | 06/27/2006 |
NPI Last Update Date: | 04/16/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP1600X |
License Number: | 0701003259 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | VA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Pastoral |
Taxonomy Definition: |