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General NPI Number Information
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NPI Number | 1972959435
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Entity Type | Individual
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Provider Name | DEBORAH BETSWORTH PHD
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Gender | Female
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Dates
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Enumeration Date | 05/13/2016
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Last Update Date | 05/13/2016
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Provider Practice Location Address
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Address Line | IOWA CITY VA HEALTH CARE SYSTEM 601 HWY 6 WEST
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City | IOWA CITY
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State | IA
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Zip | 52246
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Country | US
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Telephone | 262-573-5715
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Fax |
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Provider Business Mailing Address
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Address Line | 1600 W GREEN TREE RD, 119
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City | GLENDALE
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State | WI
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Zip | 53209
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Country | US
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Telephone | 262-573-5715
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 2119-57
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 2119-57
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License Number State | WI
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