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General NPI Number Information
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NPI Number | 1659495687
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Entity Type | Organization
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Legal Business Name | FAMILY AID, INC.
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Dates
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Enumeration Date | 03/16/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5348 VEGAS DR #67
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City | LAS VEGAS
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State | NV
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Zip | 89108-2347
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Country | US
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Telephone | 413-653-6228
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Fax |
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Provider Business Mailing Address
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Address Line | 5348 VEGAS DR #67
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City | LAS VEGAS
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State | NV
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Zip | 89108-2347
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. GARY C. BETTIS
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Credential | PH.D.
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Telephone | 413-653-6228
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 1857
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License Number State | AZ
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