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1023395126
LISSI WANDEMBURG OVERCAST
LAS CRUCES, NM
NPI
1023395126
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
235Z00000X Speech-Language Pathologist,
(Licence: NM SLP5152)
Enumeration Date
2011-11-03
Last Update Date
2022-05-18
Business Address
LISSI WANDEMBURG OVERCAST M.A.
1681 HICKORY LOOP
LAS CRUCES, NM 88005-6587
Phone number: 575-647-3773
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Mailing Address
LISSI WANDEMBURG OVERCAST M.A.
301 PERKINS DR STE B
LAS CRUCES, NM 88005-3248
Phone number: 575-526-6682
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