Tessa Penn-Smith
Individual provider Active NPI Speech-Language Pathologist · Deming, NM
NPI 1194151852 · NPPES record last updated Sep 25, 2013
Key facts
- NPI
- 1194151852
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- C-5332 (NM)
- Practice address
- 310 W Elm St
Deming, NM 88030-4123 - Phone
- (575) 546-5951
- NPI assigned
- Sep 25, 2013
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|
| C-5332 | NM | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | C-5332 | NM | Yes |
Addresses
Primary practice location
310 W Elm St
Deming, NM 88030-4123
Mailing address
1001 S Diamond Ave
Deming, NM 88030-4710
Phone (575) 546-0427
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| C-5332 | Other | NM | SLP CLINICAL FELLOW |
Other providers in Deming, NM
- Laura Parra
- Michael Parrino
- Jackolin Beth Pates-Swart
- Joseph W. Patterson
- Dana Kay Pellegrino
- Katherine Melissa Perales
- Dahlia Perez
- Regina Perkins
- Brian John Petracca
- Steve Pierce
All providers in Deming, NM · Speech-Language Pathologist 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 Sep 25, 2013. 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.