Individual
MARISSA WEST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A. CCC-SLP
Contact information
Practice address
13213 W 21ST CT STE 104, WICHITA, KS 67235-9625
(316) 295-6845
(316) 721-2291
Mailing address
13213 W 21ST CT STE 104, WICHITA, KS 67235-9625
(316) 295-6845
(316) 721-2291
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4533
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30004732380001
—
KS
Enumeration date
02/05/2021
Last updated
10/28/2022
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