Individual
WILLIAM BENTLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
YOUTH CARE-BONEM HM
Contact information
Practice address
2504 CAMINO ENTRADA, SANTA FE, NM 87507
(505) 471-5006
(505) 820-9220
Mailing address
PO BOX 28220, SANTA FE, NM 87592
(505) 471-5006
(505) 820-9220
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
L7904
—
NM
Enumeration date
09/09/2009
Last updated
09/09/2009
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