Healthcare Provider Details

I. General information

NPI: 1932410099
Provider Name (Legal Business Name): BETHANY BILLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2010
Last Update Date: 06/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2348 POST RD SUITE 107
WARWICK RI
02886-2258
US

IV. Provider business mailing address

2348 POST RD SUITE 107
WARWICK RI
02886-2258
US

V. Phone/Fax

Practice location:
  • Phone: 401-681-4637
  • Fax: 401-681-4675
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: