Provider Demographics
NPI:1326783085
Name:WEIDENBENNER, WHITNEY M
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:M
Last Name:WEIDENBENNER
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 1:3200 N 800W
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:IN
Mailing Address - Zip Code:47546-8334
Mailing Address - Country:US
Mailing Address - Phone:812-631-4739
Mailing Address - Fax:
Practice Address - Street 1:2515 N NEWTON ST.
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:IN
Practice Address - Zip Code:47546
Practice Address - Country:US
Practice Address - Phone:812-482-1722
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-27
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist