Provider Demographics
NPI:1255630430
Name:PADILLA, CARA LOUISE (SLP)
Entity type:Individual
Prefix:MRS
First Name:CARA
Middle Name:LOUISE
Last Name:PADILLA
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 VASSAR DR SE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-2822
Mailing Address - Country:US
Mailing Address - Phone:505-550-7770
Mailing Address - Fax:
Practice Address - Street 1:113 VASSAR DR SE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106-2822
Practice Address - Country:US
Practice Address - Phone:505-550-7770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-27
Last Update Date:2011-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMC-4885235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist