MEDICARE: TERESA LASHEYL BETIKU CASE MANAGER/ DOULA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374J00000X	Doula		OH
2	171M00000X	Case Manager/Care Coordinator		OH

General Provider Information

NPI Number	:	1346854551
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERESA LASHEYL BETIKU CASE MANAGER/ DOULA

Provider Business Mailing Address
First Line	:	3397 AMBERWAY CT
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45251-3307
Country	:	US
Telephone Number	:	502-436-3530
Fax Number	:

Provider Business Practice Location Address
First Line	:	3397 AMBERWAY CT
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45251-3307
Country	:	US
Telephone Number	:	502-436-3530
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/04/2020
Last Update Date	:	04/01/2024

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