Individual
WHITNEY CORDOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
1600 SUTTER PL, CLOVIS, NM 88101-4611
(575) 749-4490
Mailing address
PO BOX 19000, CLOVIS, NM 88102-9000
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP7071
NM
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1023534112
—
NM
Enumeration date
08/21/2017
Last updated
10/02/2020
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