Individual
ALICIA ELLEN ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
501 S ABILENE AVE, PORTALES, NM 88130-6380
(575) 359-3707
Mailing address
501 S ABILENE AVE, PORTALES, NM 88130-6380
(575) 359-3707
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
5575
NM
235Z00000X
Speech-Language Pathologist
5575
NM
Other
Enumeration date
08/27/2014
Last updated
08/27/2014
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