Provider Demographics
NPI:1083340913
Name:WEST, JONI (SLP)
Entity Type:Individual
Prefix:
First Name:JONI
Middle Name:
Last Name:WEST
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 717
Mailing Address - Street 2:
Mailing Address - City:GORMAN
Mailing Address - State:TX
Mailing Address - Zip Code:76454-0717
Mailing Address - Country:US
Mailing Address - Phone:254-734-2020
Mailing Address - Fax:
Practice Address - Street 1:501 ROOSEVELT ST.
Practice Address - Street 2:
Practice Address - City:GORMAN
Practice Address - State:TX
Practice Address - Zip Code:76475-7647
Practice Address - Country:US
Practice Address - Phone:254-734-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-25
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX104321235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist