Provider Demographics
NPI:1396397873
Name:WEAVER, BETHANY M (AUD)
Entity Type:Individual
Prefix:DR
First Name:BETHANY
Middle Name:M
Last Name:WEAVER
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2160 NOLL DRIVE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603
Mailing Address - Country:US
Mailing Address - Phone:717-392-4327
Mailing Address - Fax:717-435-8299
Practice Address - Street 1:226 WILLOW VALLEY LAKES DRIVE
Practice Address - Street 2:SUITE D
Practice Address - City:WILLOW STREET
Practice Address - State:PA
Practice Address - Zip Code:17584
Practice Address - Country:US
Practice Address - Phone:717-464-2144
Practice Address - Fax:717-464-4255
Is Sole Proprietor?:No
Enumeration Date:2019-07-15
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT006638237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter