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General NPI Number Information
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NPI Number | 1699195909
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Entity Type | Organization
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Legal Business Name | WEST THERAPY PRACTICE, PLLC
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Dates
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Enumeration Date | 04/25/2014
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Last Update Date | 04/25/2014
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Provider Practice Location Address
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Address Line | 2224 WALSH TARLTON LN 110
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City | AUSTIN
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State | TX
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Zip | 78746-7761
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Country | US
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Telephone | 512-586-8145
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Fax |
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Provider Business Mailing Address
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Address Line | 2224 WALSH TARLTON LN 110
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City | AUSTIN
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State | TX
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Zip | 78746-7761
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Country | US
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Telephone | 512-586-8145
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MELINDA WEST
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Credential | LCSW
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Telephone | 512-586-8145
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 54435
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License Number State | TX
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