Individual
MRS. TERA DEVON MUSKRAT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
200 SANDERS LN, RANCHOS DE TAOS, NM 87557-7809
(505) 737-6150
Mailing address
PO BOX 508, TAOS, NM 87571-0508
(505) 737-6168
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3863
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
19322208
—
NM
Enumeration date
12/14/2006
Last updated
07/08/2007
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