Individual
RUSTIN DANIEL RICHINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6135 PAINTBRUSH RD SW, DEMING, NM 88030-8079
(575) 543-8318
Mailing address
6135 PAINTBRUSH RD SW, DEMING, NM 88030-8079
(575) 543-8318
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
C-4144
NM
390200000X
Student in an Organized Health Care Education/Training Program
C-4144
NM
Other
Enumeration date
03/04/2008
Last updated
03/04/2008
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