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General NPI Number Information
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NPI Number | 1427861806
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Entity Type | Individual
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Provider Name | BETHANY MALLEY WIJESINGHE LMBT, BA
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Gender | Female
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Dates
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Enumeration Date | 01/29/2025
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Last Update Date | 01/29/2025
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Provider Practice Location Address
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Address Line | 25 REED ST STE 201
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City | ASHEVILLE
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State | NC
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Zip | 28803-3078
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Country | US
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Telephone | 612-834-2165
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Fax |
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Provider Business Mailing Address
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Address Line | 23 TERRACE CT
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City | WOODFIN
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State | NC
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Zip | 28804-7502
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Country | US
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Telephone | 612-834-2165
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 15446
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License Number State | NC
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