Healthcare Provider Details

I. General information

NPI: 1487098307
Provider Name (Legal Business Name): GRISELDA MURGUIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: GRISELDA CONTRERAS SLP

II. Dates (important events)

Enumeration Date: 04/22/2013
Last Update Date: 06/03/2022
Certification Date: 06/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1271 ANTHONY DR
ANTHONY NM
88021-9156
US

IV. Provider business mailing address

301 PERKINS DR STE B
LAS CRUCES NM
88005-3248
US

V. Phone/Fax

Practice location:
  • Phone: 575-882-3401
  • Fax: 575-882-3256
Mailing address:
  • Phone: 575-526-6682
  • Fax: 575-523-7254

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberC-5152
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSLP6591
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: