Provider Demographics
NPI:1346820024
Name:DIENNER, BETHANY NICOLE (OTR)
Entity Type:Individual
Prefix:MRS
First Name:BETHANY
Middle Name:NICOLE
Last Name:DIENNER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:MISS
Other - First Name:BETHANY
Other - Middle Name:NICOLE
Other - Last Name:STONER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:38 STRASBURG PIKE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-4120
Mailing Address - Country:US
Mailing Address - Phone:717-826-2047
Mailing Address - Fax:
Practice Address - Street 1:38 STRASBURG PIKE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-4120
Practice Address - Country:US
Practice Address - Phone:717-826-2047
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-08
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC017206225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist