institution
Sophie R. Wagner, Nm Speech-language Pathologist, Llc
Hearing and Speech Clinic/Center in Albuquerque, New Mexico
NPI 1144640947

Sophie R. Wagner, Nm Speech-language Pathologist, Llc is a Hearing and Speech Clinic/Center based in Albuquerque, NM and is specialized in Hearing and Speech. Sophie R. Wagner, Nm Speech-language Pathologist, Llc practices in Albuquerque, NM. The NPI Number for Sophie R. Wagner, Nm Speech-language Pathologist, Llc is 1144640947 and holds a License No. 5431 (New Mexico).

The current practice location address for Sophie R. Wagner, Nm Speech-language Pathologist, Llc is 1503 Central Ave Nw, Albuquerque, NM and can be reached out via phone at 505-401-8204 and via fax at 505-232-3588. You can also correspond with Sophie R. Wagner, Nm Speech-language Pathologist, Llc through the mailing address at 1503 CENTRAL AVE NW, ALBUQUERQUE, NM - 87104-1180 (mailing address contact number: 505-401-8204).

Location: 1503 Central Ave Nw, Albuquerque, NM, 87104-1180
institution
Provider Profile Details
NPI Number
1144640947
Provider Name
Sophie R. Wagner, Nm Speech-language Pathologist, Llc
Credential
Provider Entity Type
Organization
Address
1503 Central Ave Nw, Albuquerque, NM, 87104-1180
Phone Number
505-401-8204
Fax Number
505-232-3588
Provider Enumeration Date
04/18/2014
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
81888228 01 NM MEDICAID, INDIVIDUAL PROVIDER ID, NOT BILLING PROVIDER ID
47631597 05 NM
03272176005 01 NM CRS
institution
Provider Business Practice Location Address Details
Address
1503 Central Ave Nw
City
State
Zip
87104-1180
Phone Number
505-401-8204
Fax Number
505-232-3588
person
Provider Business Mailing Address Details
Address
1503 Central Ave Nw
City
State
Zip
87104-1180
Phone Number
505-401-8204
Fax Number
505-232-3588
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Hearing and Speech
Taxonomy
License No.
5431 (New Mexico)
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, prescriptive, and therapy services related to congenital and acquired conditions and diseases that affect hearing capacity and speech ability.
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