Provider Demographics
NPI:1962595181
Name:BETTILYON, MARIA C (MA)
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:C
Last Name:BETTILYON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4275 STEELS POINTE
Mailing Address - Street 2:
Mailing Address - City:STOW
Mailing Address - State:OH
Mailing Address - Zip Code:44224-6841
Mailing Address - Country:US
Mailing Address - Phone:330-923-0399
Mailing Address - Fax:330-923-6677
Practice Address - Street 1:1749 CLEVELAND RD
Practice Address - Street 2:WOOSTER ENT ASSOCIATES
Practice Address - City:WOOSTER
Practice Address - State:OH
Practice Address - Zip Code:44691
Practice Address - Country:US
Practice Address - Phone:330-264-9699
Practice Address - Fax:330-264-9644
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2018-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA01229237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter