Individual
MRS. MARY ANNE POWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M. S., CCC-SLP
Contact information
Practice address
2400 LEGACY CT, SANTA FE, NM 87507-4819
(505) 501-8623
Mailing address
2269 CALLE CACIQUE, SANTA FE, NM 87505-4909
(505) 690-3065
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3634
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000L6741
—
NM
Enumeration date
03/05/2007
Last updated
07/05/2023
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