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1598014003
PRIYA SUDARSANAM
GALLUP, NM
NPI
1598014003
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
235Z00000X Speech-Language Pathologist,
(Licence: NM 4569)
Enumeration Date
2012-08-30
Last Update Date
2012-08-30
Business Address
Ms. PRIYA SUDARSANAM MS, CCC-SLP
205 CACTUS RD
GALLUP, NM 87301-5774
Phone number: 646-942-8759
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Mailing Address
Ms. PRIYA SUDARSANAM MS, CCC-SLP
PO BOX 4625
GALLUP, NM 87305-4625
Phone number: 646-942-8759
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