Provider Demographics
NPI:1639761364
Name:ASPIRATIONS PEDIATRIC & ADULT SPEECH LANGUAGE PATHOLOGY SERVICES
Entity Type:Organization
Organization Name:ASPIRATIONS PEDIATRIC & ADULT SPEECH LANGUAGE PATHOLOGY SERVICES
Other - Org Name:ASPIRATIONS LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KRYSTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:VIGIL
Authorized Official - Suffix:
Authorized Official - Credentials:CCC- SLP
Authorized Official - Phone:505-818-7278
Mailing Address - Street 1:7216 LEW WALLACE DR NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-6313
Mailing Address - Country:US
Mailing Address - Phone:505-818-7278
Mailing Address - Fax:
Practice Address - Street 1:9004 MENAUL BLVD NE STE 14
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87112-2259
Practice Address - Country:US
Practice Address - Phone:505-818-7278
Practice Address - Fax:575-339-2817
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-04
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty