Ellen Espinosa, SLP

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

NPI 1932307147 · NPPES record last updated Jul 10, 2007

Key facts

NPI
1932307147
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
454 (NM)
Practice address
300 N 9TH St
Estancia, NM 87016
Phone
(505) 384-2000
NPI assigned
Jul 10, 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

State licenses

LicenseStateTypeSpecialty
454NMMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 454 NM Yes

Addresses

Primary practice location

300 N 9TH St
Estancia, NM 87016

Mailing address

12708 Piru Blvd SE
Albuquerque, NM 87123-3825
Phone (505) 294-3314

Other identifiers

IdentifierTypeStateIssuer
000Z2752MedicaidNM

Other providers in Estancia, NM

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

Sources for this page

Verify at the official NPI Registry.