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Individual

KAYLEIGH GENTRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.S., CFY-SLP

Contact information

Practice address
501 S ABILENE AVE, PORTALES, NM 88130-6380
(575) 359-3707
Mailing address
PO BOX 847, PORTALES, NM 88130-0847
(575) 562-4458

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
235Z00000X
NM

Other

Enumeration date
02/04/2016
Last updated
02/04/2016
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