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General NPI Number Information
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NPI Number | 1558158261
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Entity Type | Individual
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Provider Name | VIVIAN BETTS CADC INTERN
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Gender | Female
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Dates
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Enumeration Date | 04/24/2025
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Last Update Date | 04/24/2025
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Provider Practice Location Address
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Address Line | 2465 E TWAIN AVE
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City | LAS VEGAS
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State | NV
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Zip | 89121-4011
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Country | US
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Telephone | 702-789-6201
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Fax |
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Provider Business Mailing Address
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Address Line | 525 HARRIS ST APT 1424
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City | HENDERSON
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State | NV
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Zip | 89015-6170
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Country | US
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Telephone | 702-574-5212
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 07947-I
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License Number State | NV
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