Individual
MRS. ERVINA BOWANNIE SANDOVAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.CCC-SLP
Contact information
Practice address
10 NORTH SANDY SPRING ROAD, ZUNI, NM 87327-0310
(505) 782-4443
(505) 782-2600
Mailing address
PO BOX 310, 10 NORTH SANDY SPRING ROAD, ZUNI, NM 87327-0310
(505) 782-4443
(505) 782-2600
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3703
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
73452068
—
NM
Enumeration date
02/28/2007
Last updated
07/08/2007
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