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General NPI Number Information
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NPI Number | 1033959291
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Entity Type | Individual
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Provider Name | ANDRONETTE AILA M.S., CF-SLP
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Gender | Female
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Dates
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Enumeration Date | 05/27/2024
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Last Update Date | 05/27/2024
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Provider Practice Location Address
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Address Line | 1800 OLD PECOS TRL STE 1
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City | SANTA FE
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State | NM
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Zip | 87505-4759
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Country | US
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Telephone | 505-424-8777
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Fax |
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Provider Business Mailing Address
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Address Line | 2725 AGUA FRIA ST APT D101
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City | SANTA FE
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State | NM
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Zip | 87507-5520
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Country | US
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Telephone |
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Fax |
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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 | SAH-2024-0162
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License Number State | NM
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