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General NPI Number Information
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NPI Number | 1760315790
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Entity Type | Individual
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Provider Name | GWENDOLYN DENISE BETHEL
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Gender | Female
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Dates
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Enumeration Date | 06/08/2026
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Last Update Date | 06/08/2026
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Provider Practice Location Address
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Address Line | 8109 HARFORD RD STE B
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City | PARKVILLE
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State | MD
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Zip | 21234-9205
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Country | US
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Telephone | 877-500-0595
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Fax | 443-539-3020
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Provider Business Mailing Address
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Address Line | 3801 SCHNAPER DR APT 124
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City | RANDALLSTOWN
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State | MD
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Zip | 21133-2728
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Country | US
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Telephone | 443-801-0871
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Fax | 443-801-0871
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LGP14322
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License Number State | MD
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