Carla Martin, MS-SLP/CF

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

NPI 1912178005 · NPPES record last updated Mar 17, 2008

Key facts

NPI
1912178005
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
C-4285 (NM)
Practice address
200 Center St
Moriarty, NM 87035
Phone
(505) 832-5817
NPI assigned
Mar 17, 2008
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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-4285NMMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Moriarty Municipal School Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X C-4285 NM Yes

Addresses

Primary practice location

200 Center St
Moriarty, NM 87035

Mailing address

PO Box 2000
Moriarty, NM 87035-2000
Phone (505) 832-5817

Other providers in Moriarty, NM

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

Sources for this page

Verify at the official NPI Registry.