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Organization
MARY WEST
Active
Organization
MARY WEST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY B WEST MS , CCC-SLP (OWNER)
(904) 540-8408
Entity
Organization
Contact information
Practice address
1432 HEATHER COURT, ST. AUGUSTINE, FL 32092
(904) 540-8408
(904) 797-1627
Mailing address
1432 HEATHER COURT, ST. AUGUSTINE, FL 32092
(904) 540-8408
(904) 797-1627
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA3573
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
883173400
—
FL
Enumeration date
01/12/2007
Last updated
09/21/2018
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