Individual
COLLEEN WEDEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4216 BALLOON PARK RD NE, ALBUQUERQUE, NM 87109-5801
(505) 344-5470
(505) 344-9343
Mailing address
7705 BANYON AVE NW, ALBUQUERQUE, NM 87114-3507
(505) 311-3140
(505) 344-9343
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3362
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
28702069
—
NM
Enumeration date
02/28/2007
Last updated
07/08/2007
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