Individual
MS. PENNY J HUERTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
2400 S 8TH ST, TUCUMCARI, NM 88401-3726
(505) 461-4344
Mailing address
144 WILMINGTON CIR, CLOVIS, NM 88101-9311
(505) 762-7333
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3903
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02427575
—
NM
01
—
3903
STATE SLP LICENSE
NM
Enumeration date
01/20/2007
Last updated
07/08/2007
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