Provider Demographics
NPI:1477222495
Name:GILBERT-WEST, HEATHER (SLP)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:GILBERT-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 1:5 CHALAMONT WAY
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72223-5503
Mailing Address - Country:US
Mailing Address - Phone:501-247-9276
Mailing Address - Fax:
Practice Address - Street 1:5 CHALAMONT WAY
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72223-5503
Practice Address - Country:US
Practice Address - Phone:501-247-9276
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-13
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2605235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty