Doctor Name: | LUCILLE JEANETTE OLGUIN |
NPI Number: | 1699823161 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | SLP-MS |
License Number: | 1708 |
Business Practice Address: | 343 Main St Nw Los Lunas, NM - 870318712 |
Business Phone Number: | 5058659313 |
Business Fax Number: | |
Mailing Address: | 179 Tribal Road 2, BOSQUE FARMS |
State: | NM |
Postal Code: | 870688141 |
Phone Number: | 5058692698 |
Fax Number: | |
NPI Enumeration Date: | 01/08/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 1708 |
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 |