Provider Demographics
NPI:1073226494
Name:WEBB, BRIAN
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:WEBB
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:860 GLENWOOD AVE SE APT 328
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30316-2091
Mailing Address - Country:US
Mailing Address - Phone:404-493-3977
Mailing Address - Fax:
Practice Address - Street 1:860 GLENWOOD AVE SE APT 328
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30316-2091
Practice Address - Country:US
Practice Address - Phone:404-493-3977
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-30
Last Update Date:2022-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No374K00000XNursing Service Related ProvidersReligious Nonmedical Practitioner