MEDICARE: BETTE WESSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	SP-068	NV

General Provider Information

NPI Number	:	1144538810
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BETTE WESSON

Provider Business Mailing Address
First Line	:	4759 E VAN BUREN AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89110-1537
Country	:	US
Telephone Number	:	702-340-1611
Fax Number	:

Provider Business Practice Location Address
First Line	:	4759 E VAN BUREN AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89110-1537
Country	:	US
Telephone Number	:	702-340-1611
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/15/2010
Last Update Date	:	09/15/2010

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Directions to “ BETTE WESSON ” Practice Location

Language	Start Address	Practice Location

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