Individual
NICOLE L WHITEHOUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
1500 S AVENUE K # 3, PORTALES, NM 88130-7400
(575) 562-2867
Mailing address
1500 S AVENUE K # 3, PORTALES, NM 88130-7400
(575) 562-2867
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3621
WI
Other
Enumeration date
01/24/2012
Last updated
02/09/2024
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