Individual
LISA TANNEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10001 COORS BYP NW, #227, ALBUQUERQUE, NM 87114-4024
(505) 803-2072
(505) 287-8487
Mailing address
10001 COORS BYP NW, #227, ALBUQUERQUE, NM 87114-4024
(505) 803-2072
(505) 287-8487
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
305008
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q7106
—
NM
Enumeration date
03/02/2007
Last updated
07/08/2007
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