Organization
REGENTS OF NEW MEXICO STATE UNIVERSITY
Active
Other names
NMSU Hearing Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARLENE SALAS-PROVANCE PHD CCC-SLP (EXECUTIVE DIRECTOR)
(575) 646-2402
Entity
Organization
Contact information
Practice address
3600 ARROWHEAD DR, BLDG 08, LAS CRUCES, NM 88011
(575) 674-0593
Mailing address
3600 ARROWHEAD RD, BUILDING 08, LAS CRUCES, NM 88011-5129
(575) 674-0593
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
6545
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
90123280
—
NM
Enumeration date
08/18/2015
Last updated
08/18/2015
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