Individual
SHANA JUAREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9415 PERALTA RD NE, ALBUQUERQUE, NM 87109-6355
(505) 228-7550
Mailing address
9415 PERALTA RD NE, ALBUQUERQUE, NM 87109-6355
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SAH-2024-0307
NM
Other
Enumeration date
08/28/2024
Last updated
08/28/2024
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