Individual
KELLY RICE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
520 N MAIN ST, BELEN, NM 87002-3720
(505) 966-1506
Mailing address
520 N MAIN ST, BELEN, NM 87002-3720
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
76095
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
76095
LICENSE
NM
Enumeration date
11/01/2006
Last updated
07/08/2007
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