Provider Demographics
NPI:1629471586
Name:WESTBURG, ANNE MARIE (MA, ATR)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:MARIE
Last Name:WESTBURG
Suffix:
Gender:F
Credentials:MA, ATR
Other - Prefix:
Other - First Name:MARIE
Other - Middle Name:
Other - Last Name:WESTBURG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, ATR
Mailing Address - Street 1:PO BOX 84
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:MA
Mailing Address - Zip Code:01096
Mailing Address - Country:US
Mailing Address - Phone:413-588-2173
Mailing Address - Fax:
Practice Address - Street 1:203 EAST ST
Practice Address - Street 2:
Practice Address - City:EASTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01027-1234
Practice Address - Country:US
Practice Address - Phone:413-529-7277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-06
Last Update Date:2015-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No174400000XOther Service ProvidersSpecialist
No253J00000XAgenciesFoster Care Agency