Kristen Griego, M.A., CCC-SLP

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

NPI 1801439328 · NPPES record last updated Jun 24, 2024

Key facts

NPI
1801439328
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
CF6772 (NM)
Practice address
409 N California St
Socorro, NM 87801-4208
Phone
(505) 907-1902
Fax
(833) 448-2997
NPI assigned
Oct 28, 2019
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)
Yes
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
CF6772NMMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SLP7046
Speech-Language Pathologist 235Z00000X CF6772 NM Yes

Addresses

Primary practice location

409 N California St
Socorro, NM 87801-4208

Mailing address

119 Mustang Dr
Socorro, NM 87801-4451
Phone (575) 518-8815

Other practice location 1

107 Francisco De Avando St
Socorro, NM 87801-4671
Phone (575) 838-3112

Other providers in Socorro, NM

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

Sources for this page

Verify at the official NPI Registry.