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General NPI Number Information
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NPI Number | 1538836051
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Entity Type | Organization
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Legal Business Name | CREATIVE COMMUNICATION CONNECTIONS, LLC
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Dates
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Enumeration Date | 08/23/2021
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Last Update Date | 09/21/2021
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Provider Practice Location Address
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Address Line | 2167 MANUEL MEDRANO RD APT SUITE
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City | SANTA FE
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State | NM
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Zip | 87505-6998
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Country | US
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Telephone | 505-927-2521
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Fax |
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Provider Business Mailing Address
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Address Line | 2167 MANUEL MEDRANO RD
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City | SANTA FE
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State | NM
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Zip | 87505-6998
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Country | US
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Telephone | 505-927-2521
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Fax |
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Authorized Official
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Title or Position | CO-OWNER, SLP PROVIDER
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Name | CATHY M VIGIL-MARTINEZ
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Credential | M.S, CCC-SLP
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Telephone | 505-927-2521
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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 |
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License Number State |
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