Individual
MARK REN BETTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
17235 N 75TH AVE STE F100, GLENDALE, AZ 85308-0871
(480) 641-1165
Mailing address
17235 N 75TH AVE STE F100, GLENDALE, AZ 85308-0871
(480) 641-1165
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/29/2020
Last updated
07/04/2024
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