Most Relevant Information
Provider Data
| NPI Number: | 1003426800 |
| Provider Name: | BETHANY GRACE LEE LPC |
| Entity Type: | Individual |
| Taxonomy Code: | 101YP2500X |
| Specialty: | Counselor |
| License Number: | 0701009580 |
Most Important Dates
| Enumeration Date: | 08/06/2020 |
| Last Updated: | 08/06/2020 |
Provider Practice Location
508 E MAIN ST STE 500
SALEM
VA
241534325
Practice Location Phone/Fax
| Phone: | 5407728043 |
| Fax: | 5407728242 |
Provider Mailing Location
4346 STARKEY RD STE 1
ROANOKE
VA
240180605
Provider Mailing Phone/Fax
| Phone: | 5407728043 |
| Fax: | 5407728242 |