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SOPHIE R. WAGNER NM SPEECH-LANGUAGE PATHOLOGIST LLC NPI 1144640947


NPI Information

NPI: 1144640947
Provider Name: SOPHIE R. WAGNER, NM SPEECH-LANGUAGE PATHOLOGIST, LLC
Classification: Clinic/Center - 261QH0700X
Entity Type: Organization

Specialization: Hearing and Speech

Address:
1503 CENTRAL AVE NW
UNIT 202
ALBUQUERQUE, NM
ZIP 87104
Phone: (505) 401-8204
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SOPHIE R. WAGNER, NM SPEECH-LANGUAGE PATHOLOGIST, LLC is a hearing and speech clinic center in Albuquerque, NM. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, prescriptive, and therapy services related to congenital and acquired conditions and diseases that affect hearing capacity and speech ability. SOPHIE R. WAGNER, NM SPEECH-LANGUAGE PATHOLOGIST, LLC NPI is 1144640947. The provider is registered as an organization entity type.

The provider's business location address is:

1503 CENTRAL AVE NW
UNIT 202
ALBUQUERQUE, NM
ZIP 87104-180
Phone: (505) 401-8204
Fax: (505) 232-3588

The provider's authorized official is Caryn Wagner .
The authorized official title is Office Manager and has the following contact phone number (505) 980-5334.

The enumeration date for this NPI number is 4/18/2014 and was last updated on 9/4/2014.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QH0700XClinic/CenterHearing and Speech5431NEW MEXICOYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
181888228OTHERNEW MEXICOMEDICAID, INDIVIDUAL PROVIDER ID, NOT BILLING PROVIDER ID
247631597MEDICAIDNEW MEXICO
303272176005OTHERNEW MEXICOCRS

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: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.