Provider Demographics
NPI:1811538713
Name:BETZ, ERIN MARIA
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:MARIA
Last Name:BETZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:517 BENFIELD BLVD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SEVERNA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:21146
Mailing Address - Country:US
Mailing Address - Phone:410-294-9057
Mailing Address - Fax:
Practice Address - Street 1:517 BENFIELD BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:SEVERNA PARK
Practice Address - State:MD
Practice Address - Zip Code:21146
Practice Address - Country:US
Practice Address - Phone:410-294-9057
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-01
Last Update Date:2019-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
209271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical