Provider Demographics
NPI:1346854551
Name:BETIKU, TERESA LASHEYL (CASE MANAGER/ DOULA)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:LASHEYL
Last Name:BETIKU
Suffix:
Gender:F
Credentials:CASE MANAGER/ DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3397 AMBERWAY CT
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45251-3307
Mailing Address - Country:US
Mailing Address - Phone:502-436-3530
Mailing Address - Fax:
Practice Address - Street 1:3397 AMBERWAY CT
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45251-3307
Practice Address - Country:US
Practice Address - Phone:502-436-3530
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-04
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH374J00000X, 171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No374J00000XNursing Service Related ProvidersDoula