Provider Demographics
NPI:1851666846
Name:BETANCOURT, VANESSA M (AUD, CCC-A)
Entity Type:Individual
Prefix:DR
First Name:VANESSA
Middle Name:M
Last Name:BETANCOURT
Suffix:
Gender:F
Credentials:AUD, CCC-A
Other - Prefix:
Other - First Name:VANESSA
Other - Middle Name:M
Other - Last Name:BETANCOURT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2222 E HIGHLAND AVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-4872
Mailing Address - Country:US
Mailing Address - Phone:602-264-4834
Mailing Address - Fax:602-257-0082
Practice Address - Street 1:16427 N SCOTTSDALE RD STE 410
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-7102
Practice Address - Country:US
Practice Address - Phone:888-495-4489
Practice Address - Fax:602-325-0169
Is Sole Proprietor?:No
Enumeration Date:2012-03-09
Last Update Date:2019-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZDA10187231H00000X
NC9304231H00000X
AZDA-10187231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist