Provider Demographics
NPI:1679890420
Name:WEICHBRODT, JOSEPH BENNETT (BS, BHRS)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:BENNETT
Last Name:WEICHBRODT
Suffix:
Gender:M
Credentials:BS, BHRS
Other - Prefix:MR
Other - First Name:JOBE
Other - Middle Name:
Other - Last Name:WEICHBRODT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BS, BHRS
Mailing Address - Street 1:132 N WESTCHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-6639
Mailing Address - Country:US
Mailing Address - Phone:405-818-3986
Mailing Address - Fax:
Practice Address - Street 1:132 N WESTCHESTER AVE
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-6639
Practice Address - Country:US
Practice Address - Phone:405-818-3986
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-03
Last Update Date:2010-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor