Bethany Jo Mathis

NPI #1528603404 in Troy, Illinois

Provider Information

NPI Number: 1528603404
Entity Type: Individual
Name: Bethany Jo Mathis
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Developmental Therapist
Enumeration Date: Nov 14, 2019
Last Updated: Nov 14, 2019

Practice Location

Address: 411A RED BUD LN
City: Troy
State: Illinois
ZIP Code: 62294-1061
Phone: (618) 841-6021

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Developmental Therapist	222Q00000X	Primary

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