Individual
MS. TERESSA M KOFFLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
500 OWNBY ST, LORDSBURG, NM 88045-2233
(505) 542-9364
Mailing address
500 OWNBY ST, LORDSBURG, NM 88045-2233
(505) 542-9364
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1958
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000Q9604
—
NM
Enumeration date
04/09/2007
Last updated
07/09/2007
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