Provider Demographics
NPI:1932352374
Name:WEST, KATHERINE ARLENE (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:ARLENE
Last Name:WEST
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:714 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GLEN PARK
Mailing Address - State:NY
Mailing Address - Zip Code:13601-1008
Mailing Address - Country:US
Mailing Address - Phone:315-576-0636
Mailing Address - Fax:
Practice Address - Street 1:420 GAFFNEY DR
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:NY
Practice Address - Zip Code:13601-1823
Practice Address - Country:US
Practice Address - Phone:315-788-2730
Practice Address - Fax:315-788-8557
Is Sole Proprietor?:No
Enumeration Date:2008-10-29
Last Update Date:2012-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0173461235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist