Individual
ARDYCE BURNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
12701 CONSTITUTION AVE NE, CHELWOOD ES, ALBUQUERQUE, NM 87112-6082
(505) 296-5655
Mailing address
12701 CONSTITUTION AVE NE, CHELWOOD ES, ALBUQUERQUE, NM 87112-6082
(505) 296-5655
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
909
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
L 8554
—
NM
Enumeration date
01/29/2007
Last updated
07/09/2007
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