Wagner, Sophie Ruth
Wagner, Sophie Ruth is an sole proprietor health care provider with primary practice located at 1503 Central Ave Nw Unit 202, Albuquerque NM 87104-1180. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Wagner, Sophie Ruth can be contacted via phone (505) 401-8204.Contact Information
Primary practice address
1503 Central Ave Nw Unit 202
Albuquerque NM 87104-1180
Phone: (505) 401-8204
Fax: (505) 232-3593
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Speech, Language and Hearing Service Providers / Speech-Language Pathologist | 235Z00000X |
Profile Details
| NPI number | 1467703694 |
|---|---|
| LBN Legal business name | Wagner, Sophie Ruth |
| Credentials | SLP |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 27th, 2012 |
| Last updated | Sep 4th, 2014 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1467703694 | NPPES |
| New Mexico | Other | 47631597 | MEDICAID, INDIVIDUAL PROVIDER ID, NOT BILLING PROVIDER ID |
| New Mexico | MEDICAID | 47631597 | MEDICAID, INDIVIDUAL PROVIDER ID, NOT BILLING PROVIDER ID |
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