Individual
AMANDA ESPINOSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4627 12TH ST NW, ALBUQUERQUE, NM 87107-3705
(505) 280-0044
Mailing address
4617 12TH ST, ALBUQUERQUE, NM 87107
(505) 280-0044
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
C-5634
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C-5634
SLP CLINICAL FELLOW
NM
Enumeration date
11/14/2014
Last updated
04/11/2017
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