Provider Demographics
NPI:1003539909
Name:COPELAND, BETHANY (OTD)
Entity Type:Individual
Prefix:
First Name:BETHANY
Middle Name:
Last Name:COPELAND
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 W BROAD ST STE B
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:TN
Mailing Address - Zip Code:38570-1804
Mailing Address - Country:US
Mailing Address - Phone:931-823-6136
Mailing Address - Fax:931-823-6138
Practice Address - Street 1:306 W BROAD ST STE B
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:TN
Practice Address - Zip Code:38570-1804
Practice Address - Country:US
Practice Address - Phone:931-823-6136
Practice Address - Fax:931-823-6138
Is Sole Proprietor?:No
Enumeration Date:2022-09-26
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7347225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist