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General NPI Number Information
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NPI Number | 1538303474
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Entity Type | Organization
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Legal Business Name | BETZ KING PC
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Dates
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Enumeration Date | 04/22/2009
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Last Update Date | 08/13/2020
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Provider Practice Location Address
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Address Line | 26105 ORCHARD LAKE RD STE 203
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City | FARMINGTON HILLS
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State | MI
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Zip | 48334-4578
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Country | US
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Telephone | 248-417-7755
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Fax | 248-478-0435
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Provider Business Mailing Address
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Address Line | 26105 ORCHARD LAKE RD STE 203
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City | FARMINGTON HILLS
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State | MI
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Zip | 48334-4578
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Country | US
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Telephone | 248-788-5798
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Fax | 866-810-8008
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Authorized Official
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Title or Position | OWNER
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Name | DR. BETZ KING
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Credential | PSY D
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Telephone | 248-417-7755
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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