Healthcare Provider Details

I. General information

NPI: 1780170829
Provider Name (Legal Business Name): ERICA LI-JIA BETTS DO, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/02/2018
Last Update Date: 05/08/2024
Certification Date: 05/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HURLEY PLZ # 3D
FLINT MI
48503-5902
US

IV. Provider business mailing address

1 HURLEY PLZ ATTN PROFESSIONAL BILLING DEPT
FLINT MI
48503-5902
US

V. Phone/Fax

Practice location:
  • Phone: 810-262-9727
  • Fax: 810-262-7317
Mailing address:
  • Phone: 810-262-9002
  • Fax: 810-262-7317

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number5101025416
License Number StateMI

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: