Doctor Name: | TEAL HANNAH RADFORD |
NPI Number: | 1841649613 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A. |
License Number: | C-5976 |
Business Practice Address: | 325 E Buena Vista St Apt 4 Santa Fe, NM - 875052676 |
Business Phone Number: | 7632320504 |
Business Fax Number: | 5052883608 |
Mailing Address: | 325 E Buena Vista St Apt 4, SANTA FE |
State: | NM |
Postal Code: | 875052676 |
Phone Number: | 7632320504 |
Fax Number: | |
NPI Enumeration Date: | 06/12/2016 |
NPI Last Update Date: | 06/12/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | C-5976 |
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 |