Individual
CALLI BANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1500 SOUTH AVE. K, STATION 3, SHROC, PORTALES, NM 88130
(575) 562-2724
Mailing address
1500 SOUTH AVENUE K, STATION 3, SHROC, PORTALES, NM 88130
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/22/2017
Last updated
02/05/2024
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