Individual
BROOKE BETTIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2412 WATERFORD, CASPER, WY 82609-7302
(208) 670-3639
Mailing address
2412 WATERFORD, CASPER, WY 82609-7302
(208) 670-3639
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
01/03/2022
Last updated
01/03/2022
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