Provider Demographics
NPI:1184244386
Name:BENDER, WHITNEY BRIANA
Entity type:Individual
Prefix:
First Name:WHITNEY
Middle Name:BRIANA
Last Name:BENDER
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 1:13665 ROSENBERRY DR
Mailing Address - Street 2:
Mailing Address - City:FORT LOUDON
Mailing Address - State:PA
Mailing Address - Zip Code:17224-9719
Mailing Address - Country:US
Mailing Address - Phone:717-658-1180
Mailing Address - Fax:
Practice Address - Street 1:1871 OLD MAIN DR
Practice Address - Street 2:
Practice Address - City:SHIPPENSBURG
Practice Address - State:PA
Practice Address - Zip Code:17257-2200
Practice Address - Country:US
Practice Address - Phone:717-477-7447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-17
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225XM0800X
WVBP009462771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No225XM0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistMental Health