Individual
JOAN DACRESDALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
9801 ACADEMY HILLS DR NE, HUBERT HUMPHREY ES, ALBUQUERQUE, NM 87111-1311
(505) 821-4981
Mailing address
9801 ACADEMY HILLS DR NE, HUBERT HUMPHREY ES, ALBUQUERQUE, NM 87111-1311
(505) 821-4981
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3926
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8377553
—
NM
Enumeration date
01/31/2007
Last updated
07/09/2007
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