Provider Demographics
NPI:1467958074
Name:FOREMAN, BETHANY KATHLEEN
Entity Type:Individual
Prefix:
First Name:BETHANY
Middle Name:KATHLEEN
Last Name:FOREMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:246 E STATE ST
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:OH
Mailing Address - Zip Code:45701-1753
Mailing Address - Country:US
Mailing Address - Phone:937-707-8342
Mailing Address - Fax:
Practice Address - Street 1:246 E STATE ST
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701-1753
Practice Address - Country:US
Practice Address - Phone:937-707-8342
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-03
Last Update Date:2018-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker