Mcdaniel, Mandy Dawn
Mcdaniel, Mandy Dawn is an individual health care provider with primary practice located at 1600 Sutter Pl , Clovis NM 88101-4611. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Mcdaniel, Mandy Dawn can be contacted via phone (505) 769-4490.Contact Information
Primary practice address
1600 Sutter Pl
Clovis NM 88101-4611
Phone: (505) 769-4490
Fax: (505) 935-0011
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Speech, Language and Hearing Service Providers / Speech-Language Pathologist | 235Z00000X | C 3791 | New Mexico |
Profile Details
| NPI number | 1912050204 |
|---|---|
| LBN Legal business name | Mcdaniel, Mandy Dawn |
| Credentials | SLP CCC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 19th, 2007 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1912050204 | NPPES |
| New Mexico | MEDICAID | 36483389 |
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