Individual
NICOLE M ESEENMACHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
11701 SAN VICTORIO AVE NE, GEORGIA O'KEEFE ES, ALBUQUERQUE, NM 87111-5947
(505) 293-4259
Mailing address
11701 SAN VICTORIO AVE NE, GEORGIA O'KEEFE ES, ALBUQUERQUE, NM 87111-5947
(505) 293-4259
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
C 4600
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NONE ASSIGNED
—
NM
Enumeration date
11/04/2009
Last updated
11/04/2009
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