Provider Demographics
NPI:1083281877
Name:WESTEMEYER, ROSS MATTHEW (MA)
Entity Type:Individual
Prefix:
First Name:ROSS
Middle Name:MATTHEW
Last Name:WESTEMEYER
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3925 S 147TH ST STE 109-111
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144-5565
Mailing Address - Country:US
Mailing Address - Phone:402-942-1329
Mailing Address - Fax:
Practice Address - Street 1:8525 EXECUTIVE WOODS DR
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68512-9300
Practice Address - Country:US
Practice Address - Phone:402-942-1329
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-09
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE826235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist