Provider Demographics
NPI:1013132133
Name:ALTHOF, BETTE CROMER (MA)
Entity type:Individual
Prefix:MS
First Name:BETTE
Middle Name:CROMER
Last Name:ALTHOF
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1456 JACKSON PIKE
Mailing Address - Street 2:
Mailing Address - City:GALLIPOLIS
Mailing Address - State:OH
Mailing Address - Zip Code:45631-2602
Mailing Address - Country:US
Mailing Address - Phone:740-446-8289
Mailing Address - Fax:740-446-2926
Practice Address - Street 1:1456 JACKSON PIKE
Practice Address - Street 2:
Practice Address - City:GALLIPOLIS
Practice Address - State:OH
Practice Address - Zip Code:45631-2602
Practice Address - Country:US
Practice Address - Phone:740-446-8289
Practice Address - Fax:740-446-2926
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC4110101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health