Bettis, Blake
Bettis, Blake is an sole proprietor health care provider with primary practice located at 1750 Fordem Ave Apt 704 , Madison WI 53704-7135. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Bettis, Blake can be contacted via phone (470) 331-2534.Contact Information
Primary practice address
1750 Fordem Ave Apt 704
Madison WI 53704-7135
Phone: (470) 331-2534
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | 5124-57 | Wisconsin |
Profile Details
| NPI number | 1003650813 |
|---|---|
| LBN Legal business name | Bettis, Blake |
| Credentials | PSYD |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 25th, 2024 |
| Last updated | Jun 25th, 2024 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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