Individual
CRISTAL MARTINEZ VALDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
708 LA JOYA STREET, ESPANOLA, NM 87532-2877
(505) 753-6550
(505) 753-1219
Mailing address
PO BOX 1106, SANTA CRUZ, NM 87567-1106
(505) 927-1045
(505) 753-1219
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3628
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3628
PROFESSIONAL LICENSE NUMBER
NM
Enumeration date
07/13/2017
Last updated
07/13/2017
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