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MILAGRO THERAPY SERVICES LLC NPI 1124195540


NPI Information

NPI: 1124195540
Provider Name: MILAGRO THERAPY SERVICES LLC
Classification: Speech-Language Pathologist - 235Z00000X
Entity Type: Organization
Address:
220 PLAZA ST
LAS VEGAS, NM
ZIP 87701
Phone: (505) 699-1097
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MILAGRO THERAPY SERVICES LLC is a speech language pathologist in Las Vegas, NM. The provider is the speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing. MILAGRO THERAPY SERVICES LLC NPI is 1124195540. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

220 PLAZA ST
LAS VEGAS, NM
ZIP 87701-433
Phone: (505) 699-1097
Fax: (505) 454-9565

The provider's authorized official is Cynthia J Bonilla .
The authorized official title is Occupational Therapist and has the following contact phone number (505) 699-1097.

The enumeration date for this NPI number is 11/29/2006 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1235Z00000XSpeech-Language Pathologist2133NEW MEXICOYes
2225100000XPhysical Therapist3205NEW MEXICOX
3225X00000XOccupational Therapist2181NEW MEXICOX

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
116073029MEDICAIDNEW MEXICO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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