Healthcare Provider Details

I. General information

NPI: 1134714348
Provider Name (Legal Business Name): NICE SPEECH LADY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2021
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 MARQUETTE AVE NW STE 1200
ALBUQUERQUE NM
87102-5312
US

IV. Provider business mailing address

409 N CALIFORNIA ST
SOCORRO NM
87801-4208
US

V. Phone/Fax

Practice location:
  • Phone: 505-358-9946
  • Fax: 183-345-5835
Mailing address:
  • Phone: 505-358-9946
  • Fax: 833-448-2997

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: WILSON NICE
Title or Position: OWNER
Credential:
Phone: 505-358-9946