Provider Demographics
NPI:1881251916
Name:KOMMUNIKARE THERAPY PC
Entity type:Organization
Organization Name:KOMMUNIKARE THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH & LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MS
Authorized Official - First Name:TRISTIN
Authorized Official - Middle Name:L
Authorized Official - Last Name:ROAN
Authorized Official - Suffix:
Authorized Official - Credentials:MS , CCC-SLP
Authorized Official - Phone:575-631-2897
Mailing Address - Street 1:2400 N GRIMES ST STE B26
Mailing Address - Street 2:
Mailing Address - City:HOBBS
Mailing Address - State:NM
Mailing Address - Zip Code:88240-2124
Mailing Address - Country:US
Mailing Address - Phone:575-437-2001
Mailing Address - Fax:575-437-2001
Practice Address - Street 1:2400 N GRIMES ST STE B26
Practice Address - Street 2:
Practice Address - City:HOBBS
Practice Address - State:NM
Practice Address - Zip Code:88240-2124
Practice Address - Country:US
Practice Address - Phone:833-695-2731
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-23
Last Update Date:2019-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMNAOtherNA