Individual
BECKY WHITSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1107 SOUTH ELEVENTH STREET, TUCUMCARI, NM 88401
(505) 461-4344
Mailing address
1020 STATE HIGHWAY 278, GRADY, NM 88120-9608
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3022
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G7836
—
NM
Enumeration date
01/16/2007
Last updated
07/09/2007
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