Provider Demographics
NPI:1033501887
Name:BETTS, ERIN KATHARINA (MS, ATC)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:KATHARINA
Last Name:BETTS
Suffix:
Gender:F
Credentials:MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1130 ENGLEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104-1410
Mailing Address - Country:US
Mailing Address - Phone:612-807-8395
Mailing Address - Fax:
Practice Address - Street 1:1130 ENGLEWOOD AVE
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-1410
Practice Address - Country:US
Practice Address - Phone:612-807-8395
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-03
Last Update Date:2015-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN23882255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer