Provider Demographics
NPI:1689842965
Name:WEST, MEGGAN MARIE (SLP)
Entity type:Individual
Prefix:
First Name:MEGGAN
Middle Name:MARIE
Last Name:WEST
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:MEGGAN
Other - Middle Name:
Other - Last Name:WEST
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:SLP
Mailing Address - Street 1:6744 CLAYTON RD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63117-1637
Mailing Address - Country:US
Mailing Address - Phone:314-644-1978
Mailing Address - Fax:314-647-1350
Practice Address - Street 1:6744 CLAYTON RD
Practice Address - Street 2:SUITE 220
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63117-1637
Practice Address - Country:US
Practice Address - Phone:314-644-1978
Practice Address - Fax:314-647-1350
Is Sole Proprietor?:No
Enumeration Date:2008-02-20
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003010853235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO266641Medicare Oscar/Certification