Provider Demographics
NPI:1477851509
Name:LOHR, BETHANY (PHD)
Entity Type:Individual
Prefix:DR
First Name:BETHANY
Middle Name:
Last Name:LOHR
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:455 E BEACH BLVD
Mailing Address - Street 2:1513
Mailing Address - City:GULF SHORES
Mailing Address - State:AL
Mailing Address - Zip Code:36542-6624
Mailing Address - Country:US
Mailing Address - Phone:931-273-8162
Mailing Address - Fax:
Practice Address - Street 1:455 E BEACH BLVD
Practice Address - Street 2:1513
Practice Address - City:GULF SHORES
Practice Address - State:AL
Practice Address - Zip Code:36542-6624
Practice Address - Country:US
Practice Address - Phone:931-273-8162
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-14
Last Update Date:2011-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1671103TC0700X
TN2157103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical