Individual
MS. DEBRA SERENA HARBAUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS CCCSLP
Contact information
Practice address
4216 BALLOON PARK ROAD NE, COOPERATIVE EDUCATIONAL SERVICES, ALBUQUERQUE, NM 87109-5801
(505) 344-5470
(505) 344-9343
Mailing address
1330 HERTZ DR SE, ALBUQUERQUE, NM 87108-5105
(505) 270-1592
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
01106252
MD
235Z00000X
Speech-Language Pathologist
Primary
1200
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01106252
ASHA
NM
Enumeration date
11/01/2006
Last updated
07/08/2007
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