Individual
LORILEE BOURQUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
5701 MOJAVE ST NW, MARIE M HUGHES ES, ALBUQUERQUE, NM 87120-3032
(505) 897-3080
Mailing address
9500 MONTGOMERY BLVD NE, STE 215, ALBUQUERQUE, NM 87111-2579
(505) 897-3080
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1319
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
K 6084
—
NM
Enumeration date
01/29/2007
Last updated
01/26/2017
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