Individual
BETTINA PENNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CASAC
Contact information
Practice address
11 FARBER DRIVE, UNIT D, BELLPORT, NY 11713
(631) 286-0700
(631) 286-0688
Mailing address
11 FARBER DRIVE, UNIT D, BELLPORT, NY 11713
(631) 286-0700
(631) 286-0688
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
18608
NY
Other
Enumeration date
10/20/2006
Last updated
07/08/2007
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