Provider Demographics
NPI:1154569911
Name:WESTLEY, LAURA L
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:L
Last Name:WESTLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1820 W 30TH ST
Mailing Address - Street 2:APT. 100
Mailing Address - City:JOPLIN
Mailing Address - State:MO
Mailing Address - Zip Code:64804-1520
Mailing Address - Country:US
Mailing Address - Phone:417-206-9385
Mailing Address - Fax:
Practice Address - Street 1:1820 W 30TH ST
Practice Address - Street 2:APT. 100
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64804-1520
Practice Address - Country:US
Practice Address - Phone:417-206-9385
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-31
Last Update Date:2009-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker