Individual
MRS. JESSICA MALDONADO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
304 CACTUS DR, CLOVIS, NM 88101-3338
(575) 714-3192
(575) 714-3192
Mailing address
304 CACTUS DR, CLOVIS, NM 88101-3338
(575) 714-3192
(575) 714-3192
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP5607
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40509257
—
NM
Enumeration date
04/08/2011
Last updated
06/14/2024
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