Healthcare Provider Details

I. General information

NPI: 1619181815
Provider Name (Legal Business Name): BETTINA I LEHNERT PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2007
Last Update Date: 04/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10149 N 92ND ST STE 103
SCOTTSDALE AZ
85258-4557
US

IV. Provider business mailing address

10149 N 92ND ST SUITE 103
SCOTTSDALE AZ
85258-4557
US

V. Phone/Fax

Practice location:
  • Phone: 480-285-7011
  • Fax: 480-767-1730
Mailing address:
  • Phone: 480-285-7011
  • Fax: 480-767-1730

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number3233
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number3233
License Number StateAZ
# 3
Primary TaxonomyY
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License Number3233
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: