Provider Demographics
NPI:1538207428
Name:WEST, ALICIA DAWN (BS)
Entity type:Individual
Prefix:MS
First Name:ALICIA
Middle Name:DAWN
Last Name:WEST
Suffix:
Gender:F
Credentials:BS
Other - Prefix:MS
Other - First Name:ALICIA
Other - Middle Name:DAWN
Other - Last Name:MULLINS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BS
Mailing Address - Street 1:PO BOX 9054
Mailing Address - Street 2:
Mailing Address - City:GRAY
Mailing Address - State:TN
Mailing Address - Zip Code:37615-9054
Mailing Address - Country:US
Mailing Address - Phone:423-467-3600
Mailing Address - Fax:423-467-3696
Practice Address - Street 1:3169 SECOND AVE EAST
Practice Address - Street 2:WISE COUNTY BEHAVIORAL HEALTH SERVICES
Practice Address - City:BIG STONE GAP
Practice Address - State:VA
Practice Address - Zip Code:24219
Practice Address - Country:US
Practice Address - Phone:276-523-8300
Practice Address - Fax:276-523-6964
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator