MEDICARE: JASON SAENZ M.A., CFY-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	C-5566	NM

General Provider Information

NPI Number	:	1356720320
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASON SAENZ M.A., CFY-SLP

Provider Business Mailing Address
First Line	:	4156 N GOLD ST
Second Line	:
City	:	SILVER CITY
State	:	NM
Zip	:	88061-7489
Country	:	US
Telephone Number	:	575-519-0210
Fax Number	:

Provider Business Practice Location Address
First Line	:	4156 N GOLD ST
Second Line	:
City	:	SILVER CITY
State	:	NM
Zip	:	88061-7489
Country	:	US
Telephone Number	:	575-519-0210
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2015
Last Update Date	:	05/23/2015

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Directions to “ JASON SAENZ M.A., CFY-SLP” Practice Location

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