Healthcare Provider Details

I. General information

NPI: 1437774577
Provider Name (Legal Business Name): WENDI BETTING
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2020
Last Update Date: 07/28/2020
Certification Date: 07/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1240 LEE ST
CHARLOTTESVILLE VA
22908-0817
US

IV. Provider business mailing address

1240 LEE ST FL 2
CHARLOTTESVILLE VA
22908-0817
US

V. Phone/Fax

Practice location:
  • Phone: 904-762-4047
  • Fax:
Mailing address:
  • Phone: 434-924-9333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: