MEDICARE: BENJAMIN HARBER

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	235Z00000X	Speech-Language Pathologist	14067609	GA

General Provider Information

NPI Number	:	1538997184
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BENJAMIN HARBER

Provider Business Mailing Address
First Line	:	48 SILVERTHORNE CIR
Second Line	:
City	:	DOUGLASVILLE
State	:	GA
Zip	:	30134-7415
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	48 SILVERTHORNE CIR
Second Line	:
City	:	DOUGLASVILLE
State	:	GA
Zip	:	30134-7415
Country	:	US
Telephone Number	:	770-833-0708
Fax Number	:

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

Provider Enumeration Date	:	07/24/2024
Last Update Date	:	06/02/2026

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Directions to “ BENJAMIN HARBER ” Practice Location

Language	Start Address	Practice Location

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