Individual
MRS. MONICA LEIGH REBOUL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A.,SLP
Contact information
Practice address
8100 RAINBOW BLVD NW, ALBUQUERQUE, NM 87114-6090
(505) 890-0343
Mailing address
2707 HAINES AVE NE, ALBUQUERQUE, NM 87106-2638
(505) 504-8910
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4869
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NONE ASSIGNED
—
NM
Enumeration date
10/11/2011
Last updated
10/11/2011
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