Audrey Pacheco
Individual provider Active NPI Speech-Language Assistant · Roswell, NM
NPI 1154744639 · NPPES record last updated Aug 25, 2023
Key facts
- NPI
- 1154744639
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Assistant 2355S0801X
- License
- 4879 (NM)
- Practice address
- 512 S Aspen Ave
Roswell, NM 88203-1504 - Phone
- (575) 840-8486
- NPI assigned
- Feb 3, 2014
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4879 | NM | MD | Speech-Language Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Achieve Therapy Services | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Assistant | 2355S0801X | 4879 | NM | Yes |
Addresses
Primary practice location
512 S Aspen Ave
Roswell, NM 88203-1504
Mailing address
512 S Aspen Ave
Roswell, NM 88203-1504
Other providers in Roswell, NM
- Omar Nizar Osmani
- Anita Uzoamaka Osuji
- OT on Wheels Inc
- Deron C. K. Ottey
- Janice Gullas Pabellano
- Joangelique Hopida Pacquing
- Angelo Padilla
- Ben Richard Padilla
- Nathan Matthew Padilla
- Mayra Palomares Hinojos
All providers in Roswell, NM · Speech-Language Assistant in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 25, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.