Individual
MS. KIRSTEN LEKBERG ZICKEFOOSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS CCC SLP
Contact information
Practice address
1500 VERANDA RD, RIO RANCHO, NM 87124
(505) 994-0229
(505) 994-2684
Mailing address
13122 WALTON'S TAVERN RD, MONT DELIER, VA 23192
(804) 749-4222
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3749
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
057538557
—
NM
Enumeration date
04/11/2007
Last updated
04/08/2024
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