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Individual

MRS. SACHIELLE SAMEDI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CCC-SLP

Contact information

Practice address
1902 QUAIL RUN RD NE, ALBUQUERQUE, NM 87122-1170
(617) 447-1217
Mailing address
1902 QUAIL RUN RD NE, ALBUQUERQUE, NM 87122-1170
(617) 447-1217

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
6827
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
12026438
ASHA CCC
01
4905
NM STATE LICENSURE
NM
01
6827
SPEECH LANGAUGE PATH PROFESSIONAL LICENSURE
MA
Enumeration date
09/03/2008
Last updated
10/17/2011
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