Provider Demographics
NPI:1316901077
Name:WILLIAMS, BETSY LU EL (PH D)
Entity type:Individual
Prefix:DR
First Name:BETSY
Middle Name:LU EL
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PH D
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Mailing Address - Street 1:5400 PHOENIX NE
Mailing Address - Street 2:SUITE 107
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110
Mailing Address - Country:US
Mailing Address - Phone:505-872-2828
Mailing Address - Fax:505-872-2828
Practice Address - Street 1:5400 PHOENIX NE
Practice Address - Street 2:SUITE 107
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110
Practice Address - Country:US
Practice Address - Phone:505-872-2828
Practice Address - Fax:505-872-2828
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-12
Last Update Date:2013-11-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TN1495103G00000X
NM3370103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMNM100133Medicaid
NM51608OtherPRESBYTERIAN HEALTH PLAN
NM15572OtherLOVELACE HEALTH PLAN