Individual
DR. VICKIE L. WEST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
179 N CHURCH AVE STE 201, FAYETTEVILLE, AR 72701-5267
(479) 521-4909
Mailing address
PO BOX 297, FAYETTEVILLE, AR 72702-0297
(479) 521-4909
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
86-20P
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
029116
VALUE OPTIONS
AR
01
—
50286000000
QUAL CHOICE PROVIDER
AR
01
—
59194
BCBS PROVIDER NUMBER
AR
Enumeration date
01/20/2007
Last updated
05/15/2019
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