Consuelo Cruz
Individual provider Active NPI Speech-Language Pathologist · Mora, NM
NPI 1376676338 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1376676338
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 122095 (NM)
- Practice address
- Hwy 518 Ranger Rd.
Mora, NM 87732 - Phone
- (505) 387-3307
- NPI assigned
- Mar 13, 2007
- 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 |
|---|---|---|---|
| 122095 | NM | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mora Independent School | Speech-Language Pathologist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 122095 | NM | Yes |
Addresses
Primary practice location
Hwy 518 Ranger Rd.
Mora, NM 87732
Mailing address
PO Box 94
Holman, NM 87723-0094
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1600 | Medicaid | NM |
Other providers in Mora, NM
- Samuel A Aragon
- Bestcare Pharmacy-Mora LLC
- Bestcare Pharmacy-Mora, LLC
- Mary Bunker
- County of Mora Board of County Commissioners
- Nathan Christopher Duran
- Devon Denise Fox
- William Fresquez
- Clarissa Garcia
- Shantel Garcia
All providers in Mora, 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 Jul 8, 2007. 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.