NPI 1003650813

Blake Bettis, PSYD

Practitioner Psychologist Madison, WI

Practice location

Address: 1750 Fordem Ave APT 704, Madison, WI 53704-7135
Phone: (470) 331-2534

Registered specialties

Psychologist Primary

Behavioral Health & Social Service Providers Taxonomy 103T00000X Licence 5124-57 (WI)

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Registry record

NPI: 1003650813
Entity type: Individual
Sex (as registered): Male
NPI issued: 25 Jun 2024
Record last updated: 25 Jun 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.