Individual
MS. DEANNA MARI CORDOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS CCC-SLP
Contact information
Practice address
1517 S MAIN AVE, PORTALES, NM 88130-6928
(575) 749-2711
Mailing address
1517 S MAIN AVE, PORTALES, NM 88130-6928
(575) 749-2711
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP2972
NM
Other
Enumeration date
08/24/2020
Last updated
08/24/2020
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