MISS Bethany Wallace, LCSW
NPI #1003388455 in Fort Worth, Texas
Provider Information
- NPI Number
- 1003388455
- Entity Type
- Individual
- Name
- MISS Bethany Wallace, LCSW
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Social Worker - Clinical
- Credential
- LCSW
- Enumeration Date
- Dec 26, 2018
- Last Updated
- Dec 26, 2018
Practice Location
- Address
- 4686 BRISTOL TRACE TRL
- City
- Fort Worth
- State
- Texas
- ZIP Code
- 76244-6947
- Phone
- (817) 705-1586
Specialties & Taxonomy Codes
| Specialty |
|---|
| Social Worker - Clinical — Clinical |
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