Provider Demographics
NPI:1083746077
Name:BETTS, JODI KLEEH (OT)
Entity Type:Individual
Prefix:
First Name:JODI
Middle Name:KLEEH
Last Name:BETTS
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15021 PARSONS RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-4340
Mailing Address - Country:US
Mailing Address - Phone:704-651-9887
Mailing Address - Fax:610-335-4366
Practice Address - Street 1:15021 PARSONS RIDGE LN
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-4340
Practice Address - Country:US
Practice Address - Phone:704-651-9887
Practice Address - Fax:610-335-4366
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2013-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2730225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist