Provider Demographics
NPI:1851813422
Name:BETTON, ERICKA LETOINDIA
Entity Type:Individual
Prefix:MS
First Name:ERICKA
Middle Name:LETOINDIA
Last Name:BETTON
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 1:1554 BASIL ST
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36603-5019
Mailing Address - Country:US
Mailing Address - Phone:251-367-8834
Mailing Address - Fax:
Practice Address - Street 1:1554 BASIL ST
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36603-5019
Practice Address - Country:US
Practice Address - Phone:251-652-3658
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-14
Last Update Date:2017-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities