Individual
TRACEY GALLEGOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP/A
Contact information
Practice address
420 ASHLEY LN, CORRALES, NM 87048-8940
(505) 898-2474
Mailing address
194 CALLE VISTA GRANDE, BERNALILLO, NM 87004-6066
(505) 918-0700
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
6126
NM
235Z00000X
Speech-Language Pathologist
C-4603
NM
Other
Enumeration date
09/01/2009
Last updated
12/08/2016
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