Individual
BETTY JETAWO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3256 SOUTHERN DR STE 466, GARLAND, TX 75043-1533
(972) 240-5070
Mailing address
PO BOX 494462, GARLAND, TX 75049-4462
(972) 240-5070
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
3747A0650X
Attendant Care Provider
—
—
Other
Enumeration date
06/29/2009
Last updated
07/09/2020
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