MEDICARE: MRS. DEBORAH WEST M.S., CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	18736	TX

General Provider Information

NPI Number	:	1730700436
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DEBORAH WEST M.S., CCC-SLP

Provider Business Mailing Address
First Line	:	12461 FAIRFAX RIDGE PL
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78738-5475
Country	:	US
Telephone Number	:	512-529-0750
Fax Number	:

Provider Business Practice Location Address
First Line	:	1701 LOHMANS CROSSING RD
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78734-5157
Country	:	US
Telephone Number	:	512-553-6350
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/04/2020
Last Update Date	:	09/07/2021

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Directions to “ MRS. DEBORAH WEST M.S., CCC-SLP” Practice Location

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