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General NPI Number Information
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NPI Number | 1184375453
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Entity Type | Individual
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Provider Name | EMILY M BETZ OTR/L
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Gender | Female
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Dates
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Enumeration Date | 01/18/2022
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Last Update Date | 01/18/2022
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Provider Practice Location Address
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Address Line | 10611 BALTIMORE ST NE STE 200
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City | BLAINE
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State | MN
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Zip | 55449-2846
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Country | US
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Telephone | 763-755-4275
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Fax | 763-847-4814
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Provider Business Mailing Address
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Address Line | 1891 STATION PKWY NW
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City | ANDOVER
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State | MN
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Zip | 55304-3341
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Country | US
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Telephone | 763-755-4275
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Fax | 763-847-4814
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number |
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License Number State |
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