Individual
MS. GWYN O'NEAL BURD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
300 N KENTUCKY AVE, ROSWELL, NM 88201-4636
(505) 627-2875
(505) 627-2544
Mailing address
3303 BANDOLINA DR, ROSWELL, NM 88201-6738
(505) 627-9938
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3474
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
12051047
—
NM
Enumeration date
01/17/2007
Last updated
07/09/2007
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