Individual
PAULA M. MAGNUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
US HWY 64 OLD HIGH SCHOOL ROAD, SHIPROCK, NM 87420
(505) 368-5163
(505) 368-5502
Mailing address
613 TETON DR, FARMINGTON, NM 87401-9270
(505) 564-8589
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1396
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
K2557
—
NM
Enumeration date
03/15/2007
Last updated
07/08/2007
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