Individual
DEEANN STOTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
310 LA JARA ST, BLOOMFIELD, NM 87413-6626
(505) 634-3868
(505) 634-3856
Mailing address
109 CREEKSIDE VLG, AZTEC, NM 87410-4514
(505) 334-7383
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1761
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
P5847
—
NM
Enumeration date
05/21/2007
Last updated
07/09/2007
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