| NPI | 1457452971 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONNIE E STOUT Co Director Of Cd Program 505-646-2364 |
| Organization Subpart ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: NM 6545) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: NM 6545) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2020-08-22 |