Doctor Name: | PRIDE V. ZIVKOVICH |
NPI Number: | 1275653099 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS CCC-SLP |
License Number: | 3466 |
Business Practice Address: | 780 S Walnut St Bldg #7 Las Cruces, NM - 880011425 |
Business Phone Number: | 5055261161 |
Business Fax Number: | 5055231108 |
Mailing Address: | 310 W Ethel Ave, LAS CRUCES |
State: | NM |
Postal Code: | 880052014 |
Phone Number: | 5055240702 |
Fax Number: | 5055231108 |
NPI Enumeration Date: | 03/29/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 3466 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NM |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |