Doctor Name: | MARY DELAO |
NPI Number: | 1780933036 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 5184 |
Business Practice Address: | 108 Paint Trail Elephant Butte, NM - 87935 |
Business Phone Number: | 5752678290 |
Business Fax Number: | |
Mailing Address: | 108 Paint Trail, ELEPHANT BUTTE |
State: | NM |
Postal Code: | 87935 |
Phone Number: | 5752678290 |
Fax Number: | |
NPI Enumeration Date: | 08/31/2012 |
NPI Last Update Date: | 08/31/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2355S0801X |
License Number: | 5184 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NM |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Specialist/Technologist |
Taxonomy Specialization: | Speech-Language Assistant |
Taxonomy Definition: |