Individual
GINA BRACHLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1400A E 20TH ST, FARMINGTON, NM 87401-9024
(505) 599-8617
Mailing address
10404 CEDAR SPRINGS PL NW, ALBUQUERQUE, NM 87114-4758
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
C-6078
NM
Other
Enumeration date
10/21/2016
Last updated
10/21/2016
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