Provider Demographics
NPI:1033442447
Name:WEST, GRETCHEN MARIE (MA, CCC/SLP, MED)
Entity Type:Individual
Prefix:MRS
First Name:GRETCHEN
Middle Name:MARIE
Last Name:WEST
Suffix:
Gender:F
Credentials:MA, CCC/SLP, MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 JULIANA DR
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-8431
Mailing Address - Country:US
Mailing Address - Phone:413-443-7991
Mailing Address - Fax:
Practice Address - Street 1:620 LAUREL ST
Practice Address - Street 2:
Practice Address - City:LEE
Practice Address - State:MA
Practice Address - Zip Code:01238-9181
Practice Address - Country:US
Practice Address - Phone:413-243-2010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-16
Last Update Date:2009-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA361703235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist