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General NPI Number Information
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NPI Number | 1619398575
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Entity Type | Individual
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Provider Name | CELESTE AVA ALANIZ
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Gender | Female
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Dates
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Enumeration Date | 12/19/2013
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Last Update Date | 12/19/2013
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Provider Practice Location Address
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Address Line | 603 W CHISUM AVE
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City | ARTESIA
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State | NM
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Zip | 88210-2024
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Country | US
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Telephone | 575-915-2596
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1064
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City | ARTESIA
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State | NM
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Zip | 88211-1064
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Country | US
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Telephone | 575-915-2596
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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 | C-5338
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License Number State | NM
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