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NPI Code Detail

MEDICARE: MRS. BETTE EVANS WELLS M.S., L.M.H.C.

MEDICARE: MRS. BETTE EVANS WELLS M.S., L.M.H.C.
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
1101YM0800XMental Health Counselor0000776FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1Z1246OTHERFLBLUE CROSS & BLUE SHIELD

General Provider Information

NPI Number : 1194934422
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. BETTE EVANS WELLS M.S., L.M.H.C.
Provider Business Mailing Address
First Line : 3409 DEER CREEK ALBA WAY
Second Line :
City : DEERFIELD BEACH
State : FL
Zip : 33442-7932
Country : US
Telephone Number : 954-427-8420
Fax Number : 954-427-8491
Provider Business Practice Location Address
First Line : 10 FAIRWAY DR STE 217
Second Line : HILLSBORO BOULEVARD
City : DEERFIELD BEACH
State : FL
Zip : 33441-1802
Country : US
Telephone Number : 954-941-2340
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/22/2007
Last Update Date : 07/08/2007

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