Individual
MICHAEL TROUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S., CCC-SLP
Contact information
Practice address
2819 RICHMOND DR NE, ALBUQUERQUE, NM 87107-1918
(505) 883-3787
(505) 830-0106
Mailing address
6320 MICHELANGELO LN NW, ALBUQUERQUE, NM 87114-5016
(505) 269-5241
(505) 830-0106
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
C-3849
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10026771
LOVELACE HEALTH PLAN
NM
05
—
62682873
—
NM
01
—
QMYPR0072405
MOLINA HEALTH CARE
NM
Enumeration date
10/04/2006
Last updated
07/09/2007
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