Provider Demographics
NPI:1508118746
Name:WEST, NATALIE LAUREN (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:LAUREN
Last Name:WEST
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1314 OLIVE ST
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:KY
Mailing Address - Zip Code:42071-1829
Mailing Address - Country:US
Mailing Address - Phone:808-754-4962
Mailing Address - Fax:
Practice Address - Street 1:1314 OLIVE ST
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:KY
Practice Address - Zip Code:42071-1829
Practice Address - Country:US
Practice Address - Phone:808-754-4962
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-12
Last Update Date:2020-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HISP1025235Z00000X
KY241431235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist