Individual
MARJORIE S IBARRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
8121 RAINBOW BLVD NW, TIERRA ANTIGUA ES, ALBUQUERQUE, NM 87114-6192
(505) 792-3262
Mailing address
8121 RAINBOW BLVD NW, TIERRA ANTIGUA ES, ALBUQUERQUE, NM 87114-6192
(505) 792-3262
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
C 4389
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NONE ASSIGNED
—
NM
Enumeration date
10/22/2008
Last updated
10/22/2008
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