Individual
EILEEN E VASSOS-MOFFETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
4501 SEVEN BAR LOOP RD NW, SEVEN BAR ES, ALBUQUERQUE, NM 87114-5600
(505) 899-2797
Mailing address
4501 SEVEN BAR LP NW, SEVEN BAR ES, ALBUQUERQUE, NM 87114
(505) 899-2797
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1606
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
L6045
—
NM
Enumeration date
12/18/2008
Last updated
12/18/2008
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