Individual
MS. BETTE ELLEN WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
108 N KERR AVE, SUITE B-1, WILMINGTON, NC 28405-3472
(910) 620-7227
(866) 771-7963
Mailing address
3814 APPLETON WAY, WILMINGTON, NC 28412-7304
(910) 791-7447
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C004714
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
138NN
BCBS M H PROVIDER
NC
05
—
6003086
—
NC
Enumeration date
05/22/2006
Last updated
07/09/2007
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