MEDICARE: TRAVIS WESTRY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1740523380
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRAVIS WESTRY

Provider Business Mailing Address
First Line	:	18441 NW 2ND AVE
Second Line	:	SUITE 216
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33169-4517
Country	:	US
Telephone Number	:	305-501-4943
Fax Number	:	888-793-9311

Provider Business Practice Location Address
First Line	:	18441 NW 2ND AVE
Second Line	:	SUITE 216
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33169-4517
Country	:	US
Telephone Number	:	305-501-4943
Fax Number	:	888-793-9311

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/02/2013
Last Update Date	:	04/02/2013

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Directions to “ TRAVIS WESTRY ” Practice Location

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