Healthcare Provider Details

I. General information

NPI: 1073431458
Provider Name (Legal Business Name): KIMBERLY BETTIE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7272 E INDIAN SCHOOL RD STE 540
SCOTTSDALE AZ
85251-3996
US

IV. Provider business mailing address

17622 N 48TH PL
SCOTTSDALE AZ
85254-0026
US

V. Phone/Fax

Practice location:
  • Phone: 480-389-6971
  • Fax:
Mailing address:
  • Phone: 310-867-4332
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: