Provider Demographics
NPI:1467772442
Name:FITZROY, BETHANY (MS)
Entity Type:Individual
Prefix:MRS
First Name:BETHANY
Middle Name:
Last Name:FITZROY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 ESSEX ST
Mailing Address - Street 2:APARTMENT 302
Mailing Address - City:SOUTH HAMILTON
Mailing Address - State:MA
Mailing Address - Zip Code:01982-2315
Mailing Address - Country:US
Mailing Address - Phone:978-578-7190
Mailing Address - Fax:
Practice Address - Street 1:132 ESSEX ST
Practice Address - Street 2:APARTMENT 302
Practice Address - City:SOUTH HAMILTON
Practice Address - State:MA
Practice Address - Zip Code:01982-2315
Practice Address - Country:US
Practice Address - Phone:978-578-7190
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-02
Last Update Date:2011-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor