MEDICARE: JESSICA SALGADO MS, CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	SLP7932	NM

General Provider Information

NPI Number	:	1457025637
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA SALGADO MS, CCC-SLP

Provider Business Mailing Address
First Line	:	3351 CANDELARIA RD NE STE E
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87107-1953
Country	:	US
Telephone Number	:	505-850-2258
Fax Number	:	505-633-7926

Provider Business Practice Location Address
First Line	:	3351 CANDELARIA RD NE STE E
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87107-1953
Country	:	US
Telephone Number	:	505-850-2258
Fax Number	:	505-633-7926

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/02/2021
Last Update Date	:	05/26/2024

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