Individual
ALEXIS PANNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CF-SLP
Contact information
Practice address
1337 GUSDORF RD STE G, TAOS, NM 87571-6297
(575) 758-4337
Mailing address
PO BOX 134, RED RIVER, NM 87558-0134
(662) 322-7966
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
C-6206
NM
Other
Enumeration date
12/16/2017
Last updated
12/16/2017
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