Individual
KYLE MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1350 HILLRISE CIR, LAS CRUCES, NM 88011-4759
(575) 522-9528
Mailing address
1350 HILLRISE CIR, LAS CRUCES, NM 88011-4759
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
6245
NM
235Z00000X
Speech-Language Pathologist
C-6051
NM
Other
Enumeration date
10/28/2016
Last updated
04/17/2018
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