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Individual

MARCI ANN WALLACE-INNERHOFFER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
SLP

Contact information

Practice address
5200 COPPER AVE NE, ALBUQUERQUE, NM 87108-1473
(505) 255-5099
Mailing address
5200 COPPER AVE NE, ALBUQUERQUE, NM 87108-1473
(505) 255-5099

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3268
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03058034
NM
Enumeration date
09/27/2006
Last updated
07/08/2007
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