Individual
KATHLEEN YNEZ PROCTOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
6400 UPTOWN BLVD NE #360 WEST, ALBUQUERQUE, NM 87110
(505) 855-9804
Mailing address
6400 UPTOWN BLVD NE #360 WEST, ALBUQUERQUE, NM 87110
(505) 855-9804
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP5225
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SLP5225
LISCENSE NUMBER
AZ
Enumeration date
01/14/2008
Last updated
12/22/2008
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