Individual
TARA BLANCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
505 S MAIN ST STE 249, LAS CRUCES, NM 88001-1243
(575) 527-5823
Mailing address
505 S MAIN ST STE 249, LAS CRUCES, NM 88001-1243
(575) 527-5823
(806) 766-1286
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
109007
TX
235Z00000X
Speech-Language Pathologist
Primary
6194
NM
Other
Enumeration date
09/04/2014
Last updated
07/21/2022
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