Individual
LUCILLE JEANETTE OLGUIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP-MS
Contact information
Practice address
343 MAIN ST NW, LOS LUNAS, NM 87031-8712
(505) 865-9313
Mailing address
179 TRIBAL ROAD 2, BOSQUE FARMS, NM 87068-8141
(505) 869-2698
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1708
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
L5889
—
NM
Enumeration date
01/08/2007
Last updated
07/09/2007
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