Provider Demographics
NPI:1023433711
Name:WESTBERRY, MAJORIE
Entity type:Individual
Prefix:
First Name:MAJORIE
Middle Name:
Last Name:WESTBERRY
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 1:933 E G MILES PKWY STE 105
Mailing Address - Street 2:
Mailing Address - City:HINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31313-8073
Mailing Address - Country:US
Mailing Address - Phone:912-335-8486
Mailing Address - Fax:
Practice Address - Street 1:933 E G MILES PKWY STE 105
Practice Address - Street 2:
Practice Address - City:HINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:31313-8073
Practice Address - Country:US
Practice Address - Phone:912-335-8486
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-04
Last Update Date:2014-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP001657235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist