Individual
TANDI RAQUELLE FOUTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
1612 HUTTON AVE, ANIMAS ELEMENTARY SCHOOL, FARMINGTON, NM 87402-7614
(505) 599-8601
Mailing address
1612 HUTTON AVE, ANIMAS ELEMENTARY SCHOOL, FARMINGTON, NM 87402-7614
(505) 599-8601
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
322345
NM
235Z00000X
Speech-Language Pathologist
Primary
4163
NM
Other
Enumeration date
10/01/2007
Last updated
08/18/2009
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