Provider Demographics
NPI:1447502539
Name:COATES, BETTY L
Entity type:Individual
Prefix:
First Name:BETTY
Middle Name:L
Last Name:COATES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BETTY
Other - Middle Name:L
Other - Last Name:COATES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1335 SARATOGA AVE NE APT 6
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20018-1937
Mailing Address - Country:US
Mailing Address - Phone:202-650-2075
Mailing Address - Fax:
Practice Address - Street 1:1335 SARATOGA AVE NE APT #6
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20018-1937
Practice Address - Country:US
Practice Address - Phone:202-650-2075
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-12
Last Update Date:2012-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program