Provider Demographics
NPI:1750633418
Name:WEST, SHELLEY MOSER (MED, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:SHELLEY
Middle Name:MOSER
Last Name:WEST
Suffix:
Gender:F
Credentials:MED, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 PINE RD
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28560-6651
Mailing Address - Country:US
Mailing Address - Phone:919-259-0259
Mailing Address - Fax:
Practice Address - Street 1:207 PINE RD
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28560-6651
Practice Address - Country:US
Practice Address - Phone:919-259-0259
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-04
Last Update Date:2012-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9588235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist