MEDICARE: KATHRYN LYNN WEST

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	111073	TX

General Provider Information

NPI Number	:	1891263083
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHRYN LYNN WEST

Provider Business Mailing Address
First Line	:	5342 TYLER PARK LN
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77494-1670
Country	:	US
Telephone Number	:	248-506-0922
Fax Number	:

Provider Business Practice Location Address
First Line	:	5342 TYLER PARK LN
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77494-1670
Country	:	US
Telephone Number	:	248-506-0922
Fax Number	:

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

Provider Enumeration Date	:	11/06/2018
Last Update Date	:	11/06/2018

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Directions to “ KATHRYN LYNN WEST ” Practice Location

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