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General NPI Number Information
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NPI Number | 1124401476
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Entity Type | Individual
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Provider Name | BETHANY WEBER
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Gender | Female
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Dates
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Enumeration Date | 07/06/2015
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Last Update Date | 07/06/2015
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Provider Practice Location Address
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Address Line | 140 S BARCLAY ST
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City | WATERLOO
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State | IA
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Zip | 50703-3906
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Country | US
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Telephone | 319-233-5695
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Fax |
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Provider Business Mailing Address
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Address Line | 5055 NORDIC RIDGE DR
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City | CEDAR FALLS
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State | IA
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Zip | 50613-9340
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Country | US
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Telephone | 319-321-6135
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 007838
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License Number State | IA
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