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General NPI Number Information
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NPI Number | 1376725390
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Entity Type | Organization
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Legal Business Name | BETHMARK INC
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Dates
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Enumeration Date | 11/30/2007
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Last Update Date | 11/30/2007
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Provider Practice Location Address
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Address Line | 722 MORGAN BLVD SUITE G
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City | HARLINGEN
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State | TX
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Zip | 78550-5139
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Country | US
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Telephone | 956-421-2727
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2127
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City | HARLINGEN
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State | TX
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Zip | 78551-2127
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Country | US
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Telephone | 956-421-2727
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Fax |
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Authorized Official
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Title or Position | PHD, OWNER
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Name | MS. SUSAN G ANDER
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Credential | LPC, PHD
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Telephone | 956-421-2727
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | LPC12751
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License Number State | TX
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