Doctor Name: | KENNETH RAY BETTS |
NPI Number: | 1033278262 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LPCMH |
License Number: | PC 0000336 |
Business Practice Address: | 12649 Dupont Blvd Ellendale, DE - 199413307 |
Business Phone Number: | 3024247425 |
Business Fax Number: | |
Mailing Address: | 25197 Bethesda Rd, GEORGETOWN |
State: | DE |
Postal Code: | 199472546 |
Phone Number: | 3024247425 |
Fax Number: | |
NPI Enumeration Date: | 12/06/2006 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | PC 0000336 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | DE |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |