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General NPI Number Information
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NPI Number | 1891577326
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Entity Type | Individual
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Provider Name | BETHLEHEM ESHETU CHW
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Gender | Female
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Dates
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Enumeration Date | 10/18/2023
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Last Update Date | 10/18/2023
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Provider Practice Location Address
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Address Line | 2923 W CHARLESTON BLVD
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City | LAS VEGAS
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State | NV
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Zip | 89102-1925
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Country | US
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Telephone | 702-232-0353
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Fax |
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Provider Business Mailing Address
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Address Line | 7143 S DURANGO DR UNIT 206
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City | LAS VEGAS
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State | NV
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Zip | 89113-2002
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Country | US
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Telephone | 725-219-9004
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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 | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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