Individual
MRS. TERRI NIALS BACA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS CCC SLP
Contact information
Practice address
1500 S. AVE K, REGIONAL EDUCATION COOPERATIVE 6, PORTTALES, NM 88130
(575) 562-4455
Mailing address
1500 S AVENUE K, PORTALES, NM 88130-7400
(575) 562-4455
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1176
NM
Other
Enumeration date
09/27/2006
Last updated
02/03/2020
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