Marie Antonette Eichwald, M.S., CCC-SLP

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

NPI 1598898058 · NPPES record last updated Jul 9, 2007

Key facts

NPI
1598898058
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
1997 (NM)
Practice address
481 Plaza Vinedos
Bernalillo, NM 87004-6610
Phone
(505) 771-0971
Fax
(505) 771-0971
NPI assigned
Mar 13, 2007
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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
1997NMMDPeer Specialist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 1997 NM Yes

Addresses

Primary practice location

481 Plaza Vinedos
Bernalillo, NM 87004-6610

Mailing address

481 Plaza Vinedos
Bernalillo, NM 87004-6610
Phone (505) 771-0971

Other identifiers

IdentifierTypeStateIssuer
D2185MedicaidNM

Other names

  • Mrs. M. Antonette Salazar Eichwald Professional name

Other providers in Bernalillo, NM

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

Sources for this page

Verify at the official NPI Registry.