Individual
MS. MARY HATHEWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
736 ALVARADO DR SE, ALBUQUERQUE, NM 87108-3625
(505) 934-9008
Mailing address
736 ALVARADO DR SE, ALBUQUERQUE, NM 87108-3625
(505) 934-9008
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4557
NM
Other
Enumeration date
08/24/2009
Last updated
08/24/2009
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