Healthcare Provider Details

I. General information

NPI: 1457449175
Provider Name (Legal Business Name): MICHAEL ALLAN KAPLAN PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4001 OFFICE CT STE 305
SANTA FE NM
87507-4930
US

IV. Provider business mailing address

3252 CALLE DE MOLINA
SANTA FE NM
87507-9261
US

V. Phone/Fax

Practice location:
  • Phone: 505-466-7710
  • Fax: 505-466-7714
Mailing address:
  • Phone: 505-995-0415
  • Fax: 505-995-0415

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number3956
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: