=====================================================
General NPI Number Information
=====================================================
NPI Number | 1447050117
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BETTERU WELLNESS AND PSYCHIATRIC SERVICES PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/13/2025
-----------------------------------------------------
Last Update Date | 03/13/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 150 S WARNER RD
-----------------------------------------------------
City | KING OF PRUSSIA
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19406-2826
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 610-819-7449
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 150 S WARNER RD
-----------------------------------------------------
City | KING OF PRUSSIA
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19406-2826
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 610-819-7449
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | ZAKIYYAH MUHSIN-FALL
-----------------------------------------------------
Credential | PMHNP
-----------------------------------------------------
Telephone | 610-819-7449
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------