Provider Demographics
NPI:1124119003
Name:SPERING, BETTY LYNN (LISAC, MS)
Entity type:Individual
Prefix:MRS
First Name:BETTY
Middle Name:LYNN
Last Name:SPERING
Suffix:
Gender:F
Credentials:LISAC, MS
Other - Prefix:MISS
Other - First Name:BETTY
Other - Middle Name:LYNN
Other - Last Name:PATTERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:489 N ARROYO BLVD
Mailing Address - Street 2:
Mailing Address - City:NOGALES
Mailing Address - State:AZ
Mailing Address - Zip Code:85621-2644
Mailing Address - Country:US
Mailing Address - Phone:520-287-4713
Mailing Address - Fax:520-287-9794
Practice Address - Street 1:1701 N DOUGLAS AVE
Practice Address - Street 2:
Practice Address - City:DOUGLAS
Practice Address - State:AZ
Practice Address - Zip Code:85607-1019
Practice Address - Country:US
Practice Address - Phone:520-364-1286
Practice Address - Fax:520-805-1221
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLISAC10607101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ915639OtherAHCCCS