Provider Demographics
NPI:1609071000
Name:WEST, ALLISON RUTH (MS)
Entity type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:RUTH
Last Name:WEST
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:163 NE COTTON TAIL DR
Mailing Address - Street 2:
Mailing Address - City:FLETCHER
Mailing Address - State:OK
Mailing Address - Zip Code:73541-1143
Mailing Address - Country:US
Mailing Address - Phone:580-512-0181
Mailing Address - Fax:405-701-5421
Practice Address - Street 1:163 NE COTTON TAIL DR
Practice Address - Street 2:
Practice Address - City:FLETCHER
Practice Address - State:OK
Practice Address - Zip Code:73541-1143
Practice Address - Country:US
Practice Address - Phone:580-512-0181
Practice Address - Fax:405-701-5421
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-18
Last Update Date:2019-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
NA101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional