Individual
MS. ELLEN ESPINOSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
300 N 9TH ST, ESTANCIA, NM 87016
(505) 384-2000
Mailing address
12708 PIRU BLVD SE, ALBUQUERQUE, NM 87123-3825
(505) 294-3314
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
454
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000Z2752
—
NM
Enumeration date
07/10/2007
Last updated
07/10/2007
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