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Individual

CARRIE JEAN BETTENHAUSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1592 MONROE ST, NORTH BEND, OR 97459-3657
(541) 260-1003
Mailing address
3587 HEATHROW WAY, MEDFORD, OR 97504-4004

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
101YM0800X
Mental Health Counselor
Primary

Other

Enumeration date
03/05/2007
Last updated
03/24/2017
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