Provider Demographics
NPI:1326010752
Name:WESTMAN, CHARLENE ANN (MA, CCC/SLP)
Entity Type:Individual
Prefix:MS
First Name:CHARLENE
Middle Name:ANN
Last Name:WESTMAN
Suffix:
Gender:F
Credentials:MA, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:681 GOODLETTE RD N
Mailing Address - Street 2:#150
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-5458
Mailing Address - Country:US
Mailing Address - Phone:239-434-9512
Mailing Address - Fax:239-643-5908
Practice Address - Street 1:681 GOODLETTE RD N
Practice Address - Street 2:#150
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5458
Practice Address - Country:US
Practice Address - Phone:239-434-9512
Practice Address - Fax:239-643-5908
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2016-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA0000255235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL880485100Medicaid