Provider Demographics
NPI:1437597051
Name:SOTELO, MEGHAN (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:
Last Name:SOTELO
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3529 YOSEMITE DR NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-5451
Mailing Address - Country:US
Mailing Address - Phone:505-261-4345
Mailing Address - Fax:
Practice Address - Street 1:3530 PAN AMERICAN FWY NE STE D
Practice Address - Street 2:KIDPOWER THERAPY ASSOCIATES
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87107-4793
Practice Address - Country:US
Practice Address - Phone:505-888-4469
Practice Address - Fax:505-889-8142
Is Sole Proprietor?:No
Enumeration Date:2013-06-05
Last Update Date:2016-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM5308235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist