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General NPI Number Information
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NPI Number | 1740318336
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Entity Type | Organization
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Legal Business Name | SANTA FE PUBLIC SCHOOLS
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Dates
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Enumeration Date | 03/02/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 610 ALTA VISTA ST
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City | SANTA FE
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State | NM
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Zip | 87505-4149
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Country | US
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Telephone | 505-467-2502
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Fax |
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Provider Business Mailing Address
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Address Line | 2336 CAMINO DEL PRADO
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City | SANTA FE
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State | NM
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Zip | 87507-4882
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Country | US
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Telephone | 505-471-1974
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Fax |
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Authorized Official
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Title or Position | SPEECH LANGUAGE PATHOLOGIST
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Name | MS. SUSANNE CLAIRE LOCKFORD
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Credential | M.A.
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Telephone | 505-471-1974
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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 | 708
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License Number State | NM
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