| NPI | 1295900207 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA WILSON Owner/Director 505-424-8777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: NM 457) |
| Additional Taxonomies | 174400000X Specialist (Licence: NM 443) |
| Enumeration Date | 2008-04-30 |
| Last Update Date | 2011-11-29 |