Provider Demographics
NPI:1457661621
Name:WINTER, BETTY A (EDD)
Entity Type:Individual
Prefix:DR
First Name:BETTY
Middle Name:A
Last Name:WINTER
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:186 CRESTMERE PL
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38112-3202
Mailing Address - Country:US
Mailing Address - Phone:901-219-6393
Mailing Address - Fax:
Practice Address - Street 1:35 S AUBURNDALE ST
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-3916
Practice Address - Country:US
Practice Address - Phone:901-729-3900
Practice Address - Fax:901-729-2737
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-20
Last Update Date:2010-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLPC0000000579101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional