Individual
AMANDA THAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CF-SLP
Contact information
Practice address
1100 TEXAS ST NE, ALBUQUERQUE, NM 87110-7814
(505) 265-7741
Mailing address
PO BOX 25704, ALBUQUERQUE, NM 87125-0704
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
CF6972
NM
Other
Enumeration date
10/02/2020
Last updated
10/02/2020
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