Individual
MRS. ANGELICA KATHLEEN BENAVIDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
836 MARIE PARK DR NE, ALBUQUERQUE, NM 87123-1719
(505) 362-3909
(505) 323-5392
Mailing address
836 MARIE PARK DR NE, ALBUQUERQUE, NM 87123-1719
(505) 362-3909
(505) 323-5392
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2741
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
B7988
—
NM
Enumeration date
10/02/2006
Last updated
07/09/2007
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