Individual
IVONNE OLSON PENUELA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP-CF
Contact information
Practice address
330 HOLGUIN RD, VADO, NM 88072-7220
(575) 233-2861
Mailing address
PO BOX 70, ANTHONY, NM 88021-0070
(575) 882-6101
(575) 882-6926
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
C-6086
NM
Other
Enumeration date
09/27/2016
Last updated
09/27/2016
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