Individual
MS. CHRISTE ANN POLANCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A
Contact information
Practice address
4477 9TH AVE NE, RIO RANCHO, NM 87124-5634
(505) 892-7735
Mailing address
1712 BLUEBERRY DR NE, RIO RANCHO, NM 87144-6544
(505) 994-0226
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3199
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A-9286
—
NM
Enumeration date
03/02/2007
Last updated
07/08/2007
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