Individual
MRS. KATHRYN E CHAVEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS CCC-SLP
Contact information
Practice address
12 LIRIO PL, LOS LUNAS, NM 87031-5908
(505) 565-1361
Mailing address
12 LIRIO PL, LOS LUNAS, NM 87031-5908
(505) 565-1361
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2480
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00073753
—
NM
Enumeration date
12/05/2006
Last updated
07/08/2007
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