Provider Demographics
NPI:1467897496
Name:BETZING, PATRICIA JACQUELENE (LLPC)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:JACQUELENE
Last Name:BETZING
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:MS
Other - First Name:PATRICIA
Other - Middle Name:JACQUELENE
Other - Last Name:BETZING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:529 MARTIN LUTHER KING JR AVE
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48502
Mailing Address - Country:US
Mailing Address - Phone:810-238-0483
Mailing Address - Fax:810-239-5518
Practice Address - Street 1:529 MARTIN LUTHER KING JR AVE
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48502
Practice Address - Country:US
Practice Address - Phone:810-238-0483
Practice Address - Fax:810-239-5518
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-03
Last Update Date:2013-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401011229101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional