Individual
MS. LEE ELLEN WALKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
800 FRUITA RD NE, EAGLE RIDGE MIDDLE SCHOOL, RIO RANCHO, NM 87124-6557
(505) 892-6630
Mailing address
800 FRUITA RD NE, EAGLE RIDGE MIDDLE SCHOOL, RIO RANCHO, NM 87124-6557
(505) 892-6630
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4054
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
14576813
—
NM
Enumeration date
09/13/2007
Last updated
09/13/2007
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