Individual
KATIE CELISE EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., CCC-SLP
Contact information
Practice address
812 JEFFERSON ST NE, ALBUQUERQUE, NM 87110-6206
(505) 463-3276
Mailing address
812 JEFFERSON STREET NORTHEAST, ALBUQUERQUE, NM 87110
(505) 463-3276
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2606
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00067332
—
NM
Enumeration date
11/30/2006
Last updated
09/01/2011
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