| Bethany Detwiler Phd Llc | |
|
121 N Cedar Crest Blvd Ste A Allentown PA 18104-4664 | |
| (610) 467-3736 | |
| Not Available |
| Full Name | Bethany Detwiler Phd Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 121 N Cedar Crest Blvd Ste A, Allentown, Pennsylvania |
| Authorized Official Name and Position | Bethany Detwiler (LICENSED PSYCHOLOGIST) |
| Authorized Official Contact | 6104673736 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bethany Detwiler Phd Llc 6560 Fernwood Dr Coopersburg PA 18036-1011 Ph: (856) 343-9582 | Bethany Detwiler Phd Llc 121 N Cedar Crest Blvd Ste A Allentown PA 18104-4664 Ph: (610) 467-3736 |
| NPI Number | 1366927444 |
|---|---|
| Provider Enumeration Date | 09/25/2018 |
| Last Update Date | 11/24/2023 |
| Certification Date | 11/24/2023 |
| Medicare PECOS PAC ID | 0345593224 |
|---|---|
| Medicare Enrollment ID | O20181023000357 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366927444 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Bethany P Detwiler |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1316491061 PECOS PAC ID: 1456649995 Enrollment ID: I20161015000145 |
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