Individual
MS. MAXINE HACKNEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
4720 CAIRO DR NE, ALBUQUERQUE, NM 87111-2617
(505) 296-9536
Mailing address
7112-89 PAN AMERICAN EAST FWY NE, ALBUQUERQUE, NM 87109-4236
(505) 884-9736
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1385
NM
Other
Enumeration date
11/29/2006
Last updated
07/08/2007
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