Charlotte A Belton, MA,CCC-SLP

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

NPI 1720116783 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1720116783
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
3764 (NM)
Practice address
N Hwy 63
Pecos Independent Schools
Pecos, NM 87552
Phone
(505) 757-4644
NPI assigned
Mar 1, 2007
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 Arts

State licenses

LicenseStateTypeSpecialty
3764NMMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 3764 NM Yes

Addresses

Primary practice location

N Hwy 63
Pecos Independent Schools
Pecos, NM 87552

Mailing address

110 San Salvador LN
Santa Fe, NM 87501-1740
Phone (505) 995-9776

Other identifiers

IdentifierTypeStateIssuer
84852879MedicaidNM

Other providers in Pecos, NM

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

Sources for this page

Verify at the official NPI Registry.