Individual
ANA BETANCOURT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1 MONMOUTH SQ, EAST BOSTON, MA 02128-1319
(617) 569-4561
(617) 568-9778
Mailing address
200 BROADSOUND AVE, REVERE, MA 02151-3751
(617) 331-3814
(617) 568-9778
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
4712
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LM1187
BLUE CROSS BLUE SHIELD
MA
Enumeration date
03/08/2007
Last updated
07/08/2007
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