Provider Demographics
NPI:1851000657
Name:WEISENSEL, HAILEY (RBT)
Entity Type:Individual
Prefix:
First Name:HAILEY
Middle Name:
Last Name:WEISENSEL
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT HOREB
Mailing Address - State:WI
Mailing Address - Zip Code:53572-2206
Mailing Address - Country:US
Mailing Address - Phone:608-438-5207
Mailing Address - Fax:
Practice Address - Street 1:120 RIDGE DR
Practice Address - Street 2:
Practice Address - City:MOUNT HOREB
Practice Address - State:WI
Practice Address - Zip Code:53572-2206
Practice Address - Country:US
Practice Address - Phone:608-438-5207
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-21
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician