Healthcare Provider Details

I. General information

NPI: 1275003527
Provider Name (Legal Business Name): VICTORIA LYNN WEBER MS, CGC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2018
Last Update Date: 11/29/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1447 HARPER ST # BP5353
AUGUSTA GA
30912-0020
US

IV. Provider business mailing address

1120 15TH ST # BP5353
AUGUSTA GA
30912-0004
US

V. Phone/Fax

Practice location:
  • Phone: 67-211-5677
  • Fax: 706-721-6673
Mailing address:
  • Phone: 706-721-9615
  • Fax: 706-446-2829

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: