Provider Demographics
NPI:1619181815
Name:LEHNERT, BETTINA I (PHD)
Entity Type:Individual
Prefix:DR
First Name:BETTINA
Middle Name:I
Last Name:LEHNERT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10149 N 92ND ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-4557
Mailing Address - Country:US
Mailing Address - Phone:480-285-7011
Mailing Address - Fax:480-767-1730
Practice Address - Street 1:10149 N 92ND ST
Practice Address - Street 2:STE 103
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4557
Practice Address - Country:US
Practice Address - Phone:480-285-7011
Practice Address - Fax:480-767-1730
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2010-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3233103TC0700X, 103TC2200X, 103TF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent