Patriarca, Gwen

Patriarca, Gwen is an sole proprietor health care provider with primary practice located at 1600 Sutter Place Student Support Center, Clovis NM 88012-9000. She recently has 2 registered licenses in different health care specialties including Speech, Language and Hearing Service Providers / Speech-Language Pathologist, Speech, Language and Hearing Service Providers / Audiologist. Speech, Language and Hearing Service Providers / Audiologist is her primary health care specialty. Patriarca, Gwen can be contacted via phone (575) 769-4490.

Contact Information

Primary practice address
1600 Sutter Place Student Support Center Clovis NM 88012-9000
Phone: (575) 769-4490
Fax: (575) 769-4533
Website:
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Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X 655 New Mexico
Speech, Language and Hearing Service Providers / Audiologist 231H00000X 655 New Mexico

Profile Details

NPI number 1679606677
LBN Legal business name Patriarca, Gwen
Credentials SLP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 13th, 2007
Last updated Nov 1st, 2017 - about 9 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679606677 NPPES
New Mexico MEDICAID K 3216

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