Healthcare Provider Details

I. General information

NPI: 1689581936
Provider Name (Legal Business Name): ELIZABETH ALEJANDRA ARELLANO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4004 CARLISLE BLVD NE
ALBUQUERQUE NM
87107-4565
US

IV. Provider business mailing address

1508 34TH CIR SE
RIO RANCHO NM
87124-1978
US

V. Phone/Fax

Practice location:
  • Phone: 505-710-3833
  • Fax:
Mailing address:
  • Phone: 661-380-9324
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSAH-2026-0305
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: