Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225CA2400X | Assistive Technology Practitioner | 91685 | TX |
NPI | 1407458748 |
---|---|
Provider Name | John Joseph West |
First Address | Irving, TX 75038-3027 |
Second Address | Irving, TX 75038-3027 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/11/2020 |
Last Update Date | 11/11/2020 |