Individual
MOIRA LOUISE ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6400 UPTOWN BLVD NE, SUITE 360 WEST, ALBUQUERQUE, NM 87110-4204
(505) 855-9805
(505) 848-9468
Mailing address
800 BRADBURY DR SE STE 116, ALBUQUERQUE, NM 87106-4310
(505) 272-1476
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
C-5721
NM
235Z00000X
Speech-Language Pathologist
Primary
SLP5922
NM
Other
Enumeration date
04/09/2015
Last updated
02/14/2025
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