Individual
MARY VICTORIA CANSINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1600 N MAIN AVE, LOVINGTON, NM 88260-2813
(361) 492-9120
Mailing address
1600 N MAIN AVE, LOVINGTON, NM 88260-2813
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
CF6812
NM
Other
Enumeration date
04/27/2020
Last updated
04/27/2020
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