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General NPI Number Information
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NPI Number | 1033249669
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Entity Type | Individual
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Provider Name | ROSELIA ANDUJO MOLINA M.A. SLP
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Gender | Female
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 900 CENTRAL
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City | BAYARD
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State | NM
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Zip | 88023
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Country | US
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Telephone | 505-537-4030
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Fax | 505-537-3921
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Provider Business Mailing Address
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Address Line | 804 S 12TH ST
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City | DEMING
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State | NM
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Zip | 88030
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Country | US
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Telephone | 505-494-7014
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Fax | 505-537-3921
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 1715
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License Number State | NM
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