Provider Demographics
NPI:1437485380
Name:WEST, ERIN R (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:R
Last Name:WEST
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:237 SHERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34210-4523
Mailing Address - Country:US
Mailing Address - Phone:941-928-5327
Mailing Address - Fax:
Practice Address - Street 1:350 BRADEN AVE
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34243-2001
Practice Address - Country:US
Practice Address - Phone:941-355-7637
Practice Address - Fax:941-359-1555
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-28
Last Update Date:2011-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA10917235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist