Individual
MS. MARY MOCHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.T.
Contact information
Practice address
1115 N. CALIFORNIA ST., SOCORRO, NM 87801-0642
(505) 838-0800
(505) 838-3999
Mailing address
PO BOX 642, SOCORRO, NM 87801-0642
(505) 838-0800
(505) 838-3999
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1447
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00P3051
—
NM
05
—
84521228
—
NM
05
—
D4005
—
NM
05
—
L5902
—
NM
Enumeration date
02/14/2007
Last updated
07/09/2007
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