Provider Demographics
NPI:1891138046
Name:BUTLER, BETTY J (MSW)
Entity Type:Individual
Prefix:MS
First Name:BETTY
Middle Name:J
Last Name:BUTLER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1326 CONIFER CT
Mailing Address - Street 2:
Mailing Address - City:DELAND
Mailing Address - State:FL
Mailing Address - Zip Code:32720-8464
Mailing Address - Country:US
Mailing Address - Phone:386-748-3910
Mailing Address - Fax:
Practice Address - Street 1:1326 CONIFER CT
Practice Address - Street 2:
Practice Address - City:DELAND
Practice Address - State:FL
Practice Address - Zip Code:32720-8464
Practice Address - Country:US
Practice Address - Phone:386-748-3910
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-08
Last Update Date:2013-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator