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Organization

ALL AGES SPEECH THERAPY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JACOB MATTHEW OSBORN (MS CCC-SLP)
(765) 720-8293
Entity
Organization

Contact information

Practice address
1500 5TH ST STE 3, SANTA FE, NM 87505-3480
(505) 289-1838
Mailing address
16 DESCANSO RD, SANTA FE, NM 87508-9125
(765) 720-8293

Taxonomy

Speciality
Code
Description
License number
State
261QH0700X
Hearing and Speech Clinic/Center
Primary

Other

Enumeration date
06/04/2025
Last updated
06/04/2025
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