Yesenia Pagan

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

NPI 1659896165 · NPPES record last updated Aug 4, 2017

Key facts

NPI
1659896165
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
C-6098 (NM)
Practice address
300 E Lisa Dr
Chaparral, NM 88081-7927
Phone
(575) 824-4722
NPI assigned
Aug 4, 2017
Sex
Female
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
C-6098NMMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Gadsden Independent School District Past Accepting new patients
Gadsden Independent School District Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X C-6098 NM Yes

Addresses

Primary practice location

300 E Lisa Dr
Chaparral, NM 88081-7927

Mailing address

PO Drawer 70
Anthony, NM 88021
Phone (575) 882-6101

Other providers in Chaparral, NM

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

Sources for this page

Verify at the official NPI Registry.