Provider Demographics
NPI:1417339573
Name:WEST, CIERRA (MOT)
Entity Type:Individual
Prefix:
First Name:CIERRA
Middle Name:
Last Name:WEST
Suffix:
Gender:F
Credentials:MOT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6000 HAMPTON CTR
Mailing Address - Street 2:SUITE B
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505-1748
Mailing Address - Country:US
Mailing Address - Phone:304-599-9250
Mailing Address - Fax:304-599-7800
Practice Address - Street 1:6000 HAMPTON CTR
Practice Address - Street 2:SUITE B
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505-1748
Practice Address - Country:US
Practice Address - Phone:304-599-9250
Practice Address - Fax:304-599-7800
Is Sole Proprietor?:No
Enumeration Date:2015-06-25
Last Update Date:2015-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVLPT384225X00000X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist