Individual
MS. BRENDA BETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.,CCC-SLP
Contact information
Practice address
4201 LAKE BOONE TRL, SUITE 4, RALEIGH, NC 27607-7511
(919) 781-4434
(919) 781-5851
Mailing address
4201 LAKE BOONE TRL, SUITE 4, RALEIGH, NC 27607-7511
(919) 781-4434
(919) 781-5851
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
—
—
235Z00000X
Speech-Language Pathologist
Primary
10189
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001569200
—
FL
05
—
002186600
—
FL
Enumeration date
11/09/2009
Last updated
02/06/2013
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