Doctor Name: | MRS. CAROL ANNE BETTINO |
NPI Number: | 1184714503 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A. L.P.C. |
License Number: | LPC-0033 |
Business Practice Address: | 3343 N Windsong Dr Suite 1 Prescott Valley, AZ - 863141213 |
Business Phone Number: | 9287724185 |
Business Fax Number: | 9287724183 |
Mailing Address: | 3343 N Windsong Dr, Suite 1 PRESCOTT VALLEY |
State: | AZ |
Postal Code: | 863141213 |
Phone Number: | 9287724185 |
Fax Number: | 9287724183 |
NPI Enumeration Date: | 10/14/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | LPC-0033 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |