Individual
VIRGINIA BENTLEYGUNTHORPE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
721 TOMASITA ST NE, KENNEDY MS, ALBUQUERQUE, NM 87123-1251
(505) 298-6701
Mailing address
721 TOMASITA ST NE, KENNEDY MS, ALBUQUERQUE, NM 87123-1251
(505) 298-6701
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3021
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
G 6166
—
NM
Enumeration date
01/29/2007
Last updated
07/09/2007
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