Individual
CAROLEE DEAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
8509 HAMPTON AVE NE, ALBUQUERQUE, NM 87122-2675
(505) 323-9272
(505) 875-0801
Mailing address
8509 HAMPTON AVE NE, ALBUQUERQUE, NM 87122-2675
(505) 323-9272
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2621
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10026761
LOVELACE HEALTH PLAN
NM
05
—
12950271
—
NM
01
—
QMYPR0072410
MOLINA HEALTHCARE
NM
Enumeration date
10/04/2006
Last updated
07/09/2007
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