Provider Demographics
NPI:1467598821
Name:GREMEL, BETHANY LYNN (BS)
Entity Type:Individual
Prefix:
First Name:BETHANY
Middle Name:LYNN
Last Name:GREMEL
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7108 SWEETGUM RD
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW
Mailing Address - State:TN
Mailing Address - Zip Code:37062-9383
Mailing Address - Country:US
Mailing Address - Phone:615-604-1290
Mailing Address - Fax:
Practice Address - Street 1:209 HENSLEE DR
Practice Address - Street 2:
Practice Address - City:DICKSON
Practice Address - State:TN
Practice Address - Zip Code:37055-2089
Practice Address - Country:US
Practice Address - Phone:615-446-7650
Practice Address - Fax:615-446-7715
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health