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Individual

GEORGIA DIXON BERBERT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSOT, OTR/L

Contact information

Practice address
11840 S LA CIENEGA BLVD, HAWTHORNE, CA 90250-3459
(424) 269-3400
(310) 882-5451
Mailing address
9565 HWY 78, BLDG 700 STE 102, LADSON, SC 29456-4116
(843) 314-5434
(888) 510-9156

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
0005530
CO
225X00000X
Occupational Therapist
Primary
22659
CA
225X00000X
Occupational Therapist
5069
SC

Other

Enumeration date
09/07/2017
Last updated
08/23/2021
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