Provider Demographics
NPI:1518412873
Name:WEST, LAURA CHRISTINE
Entity type:Individual
Prefix:MS
First Name:LAURA
Middle Name:CHRISTINE
Last Name:WEST
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:LAURA
Other - Middle Name:CHRISTINE
Other - Last Name:HERRICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC
Mailing Address - Street 1:1344 DISC DR # 395
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89436-0684
Mailing Address - Country:US
Mailing Address - Phone:775-830-1795
Mailing Address - Fax:
Practice Address - Street 1:1344 DISC DR # 395
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89436-0684
Practice Address - Country:US
Practice Address - Phone:775-830-1795
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-16
Last Update Date:2016-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVSP-965235Z00000X
CASP-21595235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist