Individual
MS. JACQUELINE ROSE BERENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
213 QUINCY ST NE, ALBUQUERQUE, NM 87108-1342
(505) 385-3392
Mailing address
213 QUINCY ST NE, ALBUQUERQUE, NM 87108-1342
(505) 385-3392
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4852
NM
Other
Enumeration date
08/15/2012
Last updated
08/15/2012
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