Individual
LISA R BETTIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
705 N 4TH ST, AUMSVILLE, OR 97325
(541) 401-0851
Mailing address
705 N 4TH ST, AUMSVILLE, OR 97325-8944
(541) 401-0851
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
L3874
OR
1041C0700X
Clinical Social Worker
Primary
L3874
OR
Other
Enumeration date
10/17/2006
Last updated
08/20/2024
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