Provider Demographics
NPI:1013197151
Name:HAUER, BETHANY B (MS, OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:BETHANY
Middle Name:B
Last Name:HAUER
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:MRS
Other - First Name:BETHANY
Other - Middle Name:B
Other - Last Name:CROCKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, OTR/L
Mailing Address - Street 1:9770 GREINER RD
Mailing Address - Street 2:
Mailing Address - City:CLARENCE
Mailing Address - State:NY
Mailing Address - Zip Code:14031-1215
Mailing Address - Country:US
Mailing Address - Phone:716-741-7110
Mailing Address - Fax:
Practice Address - Street 1:BUFFALO HEARING AND SPEECH
Practice Address - Street 2:50 EAST NORTH ST
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14203
Practice Address - Country:US
Practice Address - Phone:716-885-8318
Practice Address - Fax:716-885-0229
Is Sole Proprietor?:No
Enumeration Date:2007-11-06
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0127911225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist