Provider Demographics
NPI:1063252237
Name:BILLINGSLEY, MAYA S
Entity type:Individual
Prefix:
First Name:MAYA
Middle Name:S
Last Name:BILLINGSLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1131 S HOUSTON LAKE RD APT 3100
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088-2895
Mailing Address - Country:US
Mailing Address - Phone:478-972-1901
Mailing Address - Fax:
Practice Address - Street 1:1131 S HOUSTON LAKE RD APT 3100
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088-2895
Practice Address - Country:US
Practice Address - Phone:478-972-1901
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-27
Last Update Date:2024-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach