Individual provider · NPI-1

Brianna Isabel Bayardo

Speech-Language Pathologist, · Los Lunas, NM

NPI number1457022949
StatusActive
Last updated in NPPESSep 23, 2021

Details

NPI
1457022949
Entity type
Individual (NPI-1)
Name
Brianna Isabel Bayardo
Sex
Female
Sole proprietor
No
Enumeration date
Sep 23, 2021
Certification date
Sep 23, 2021
Last updated
Sep 23, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
235Z00000X Speech-Language Pathologist,CF7502–Yes

Practice location

454 Coronado St Ne
Los Lunas, NM 87031-8709

Phone 505-866-0456

Mailing address

1804 Via Del Sol Ne
Albuquerque, NM 87110-4958

Phone 505-500-5463

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