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Individual

CYNTHIA LAVIECE POLK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
520 W 5TH ST, PORTALES, NM 88130-6329
(575) 356-7075
Mailing address
212 E PLAZA DR, CLOVIS, NM 88101-3534
(575) 791-2725

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SAH-2025-0263
NM

Other

Enumeration date
08/26/2025
Last updated
08/26/2025
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