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NPI Code Detail

MEDICARE: BETOUL ALI

MEDICARE: BETOUL ALI
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
1103K00000XBehavior Analyst

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1770294373
Entity Type Code : Individual
Provider Name (Legal Business Name) : BETOUL ALI
Provider Business Mailing Address
First Line : 1107 E CESAR E CHAVEZ AVE
Second Line :
City : LANSING
State : MI
Zip : 48906-5457
Country : US
Telephone Number : 517-884-1882
Fax Number :
Provider Business Practice Location Address
First Line : 1107 E CESAR E CHAVEZ AVE
Second Line :
City : LANSING
State : MI
Zip : 48906-5457
Country : US
Telephone Number : 517-884-1882
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/06/2022
Last Update Date : 12/06/2022

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Directions to “ BETOUL ALI ” Practice Location

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