Individual
KRUPANIDHI PRAKASH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1300 CAMINO SIERRA VISTA, OSW, SANTA FE, NM 87505
(505) 467-2504
Mailing address
1300 CAMINO SIERRA VISTA, OSW, SANTA FE, NM 87505
(505) 467-2504
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SAH-2024-0112
NM
Other
Enumeration date
11/08/2024
Last updated
11/08/2024
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