Debra Sue Campos, MS CCC SLP

Individual provider Active NPI Speech-Language Pathologist · Hagerman, NM

NPI 1326111436 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1326111436
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
1547 (NM)
Practice address
300 N Cambridge
Hagerman Schools
Hagerman, NM 88232
Phone
(505) 752-3279
NPI assigned
Nov 16, 2006
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
1547NMMDPeer Specialist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 1547 NM Yes

Addresses

Primary practice location

300 N Cambridge
Hagerman Schools
Hagerman, NM 88232

Mailing address

11 Huerta CT
Roswell
Roswell, NM 88201
Phone (505) 623-8171

Other identifiers

IdentifierTypeStateIssuer
69736MedicaidNM

Other providers in Hagerman, NM

All providers in Hagerman, NM · Speech-Language Pathologist in New Mexico

Sources for this page

Verify at the official NPI Registry.