Provider Demographics
NPI:1083248447
Name:WEBERPAL, BETHANY LYN
Entity Type:Individual
Prefix:
First Name:BETHANY
Middle Name:LYN
Last Name:WEBERPAL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3412 CRICKETEER DR
Mailing Address - Street 2:
Mailing Address - City:JANESVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53546-9657
Mailing Address - Country:US
Mailing Address - Phone:608-449-5146
Mailing Address - Fax:
Practice Address - Street 1:200 W MILWAUKEE ST
Practice Address - Street 2:
Practice Address - City:JANESVILLE
Practice Address - State:WI
Practice Address - Zip Code:53548-2916
Practice Address - Country:US
Practice Address - Phone:608-273-3232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-25
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics