Basic Information
| Provider Information | |||||||||
| NPI: | 1689842965 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WEST | ||||||||
| FirstName: | MEGGAN | ||||||||
| MiddleName: | MARIE | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | SLP | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | WEST | ||||||||
| OtherFirstName: | MEGGAN | ||||||||
| OtherMiddleName: | |||||||||
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| OtherCredential: | SLP | ||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 6744 CLAYTON RD | ||||||||
| Address2: | SUITE 220 | ||||||||
| City: | SAINT LOUIS | ||||||||
| State: | MO | ||||||||
| PostalCode: | 631171637 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3146441978 | ||||||||
| FaxNumber: | 3146471350 | ||||||||
| Practice Location | |||||||||
| Address1: | 6744 CLAYTON RD | ||||||||
| Address2: | SUITE 220 | ||||||||
| City: | SAINT LOUIS | ||||||||
| State: | MO | ||||||||
| PostalCode: | 631171637 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3146441978 | ||||||||
| FaxNumber: | 3146471350 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/20/2008 | ||||||||
| LastUpdateDate: | 02/20/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 2003010853 | MO | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.