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General NPI Number Information
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NPI Number | 1053394072
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Entity Type | Organization
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Legal Business Name | LYNNE G WESTBERRY PHD PA
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Dates
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Enumeration Date | 11/23/2005
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Last Update Date | 07/08/2016
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Provider Practice Location Address
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Address Line | 1515 N UNIVERSITY DR SUITE 203
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City | CORAL SPRINGS
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State | FL
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Zip | 33071-8914
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Country | US
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Telephone | 954-341-7778
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Fax |
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Provider Business Mailing Address
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Address Line | 1515 N UNIVERSITY DR SUITE 203
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City | CORAL SPRINGS
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State | FL
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Zip | 33071-6096
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Country | US
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Telephone | 954-341-7778
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LYNNE G WESTBERRY
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Credential | PHD
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Telephone | 954-341-7778
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY3771
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License Number State | FL
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