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General NPI Number Information
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NPI Number | 1992875843
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Entity Type | Organization
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Legal Business Name | WEBER THERAPY ASSOCIATES, INC.
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Dates
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Enumeration Date | 11/08/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 302 DURDEN ST
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City | VIDALIA
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State | GA
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Zip | 30474-4606
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Country | US
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Telephone | 912-537-6130
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Fax | 912-537-6130
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Provider Business Mailing Address
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Address Line | 302 DURDEN ST
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City | VIDALIA
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State | GA
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Zip | 30474-4606
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Country | US
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Telephone | 912-537-6130
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Fax | 912-537-6130
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Authorized Official
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Title or Position | SPEECH-LANGUAGE PATHOLOGIST
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Name | MS. KELLY BETH WEBER
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Credential | M.ED. CCC SLP
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Telephone | 912-537-6130
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 003625
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License Number State | GA
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