Destinee Renae Gabaldon
Individual provider Active NPI Speech-Language Assistant · Las Cruces, NM
NPI 1376184697 · NPPES record last updated Nov 25, 2024
Key facts
- NPI
- 1376184697
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Assistant 2355S0801X
- License
- SLPA14281 (AZ)
- Practice address
- 505 S Main St Ste 249
Las Cruces, NM 88001-1243 - Phone
- (575) 527-5823
- NPI assigned
- Oct 8, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|
| SLPA14281 | AZ | MD | Speech-Language Assistant |
| SLPA6936 | NM | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Las Cruces School District No. 2 | Current |
Accepting new patients |
Locations
505 S Main St
Ste 249
Las Cruces, NM 88001
Phone (575) 527-5823
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SLPA6936 | NM | |
| Speech-Language Assistant | 2355S0801X | SLPA14281 | AZ | Yes |
Addresses
Primary practice location
505 S Main St Ste 249
Las Cruces, NM 88001-1243
Mailing address
505 S Main St Ste 249
Las Cruces, NM 88001-1243
Phone (575) 527-5823
Other providers in Las Cruces, NM
- Function Therapy Specialists, Inc
- John Perry Funk
- Todd Funkhouser
- Fyi Childrens Safehouse Cac
- G. Ann Remick-Barlow and Associates, LLC
- Gene Alan Gabaldon
- Kyle Clayton Gabioud
- Gabriel a Hernandez
- Brian Gafford
- Michael Elias Galban
All providers in Las Cruces, 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 Nov 25, 2024. 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.