Individual
TANA POOL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP-CF
Contact information
Practice address
1350 HILLRISE CIR, LAS CRUCES, NM 88011-4759
(575) 522-9528
Mailing address
733 STAGECOACH DR, LAS CRUCES, NM 88011-8013
(505) 553-0792
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
C-5130
NM
Other
Enumeration date
07/06/2012
Last updated
07/06/2012
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