Provider Demographics
NPI:1073950804
Name:BETTS, HEATHER (MA)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:BETTS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:552 WASHINGTON AVE
Mailing Address - Street 2:UNIT D
Mailing Address - City:CARNEGIE
Mailing Address - State:PA
Mailing Address - Zip Code:15106
Mailing Address - Country:US
Mailing Address - Phone:412-429-1908
Mailing Address - Fax:412-429-0800
Practice Address - Street 1:552 WASHINGTON AVE.
Practice Address - Street 2:UNIT D
Practice Address - City:CARNEGIE
Practice Address - State:PA
Practice Address - Zip Code:15106
Practice Address - Country:US
Practice Address - Phone:412-429-1908
Practice Address - Fax:412-429-0800
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-03
Last Update Date:2014-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH000214103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst