Individual
STAN PICKETT JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1337 GUSDORF RD STE G, TAOS, NM 87571-6297
(575) 758-4337
Mailing address
513 ZIA ST, TAOS, NM 87571-5137
(314) 369-5085
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
SAH-2026-0017
NM
Other
Enumeration date
03/19/2026
Last updated
03/19/2026
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