Provider Demographics
NPI:1649799776
Name:BILINGUALMULTICULTURAL EDUCATION SUPPORT TEAM
Entity type:Organization
Organization Name:BILINGUALMULTICULTURAL EDUCATION SUPPORT TEAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:AMOS
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CFY-SLP
Authorized Official - Phone:505-974-0137
Mailing Address - Street 1:5200 COPPER AVE NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87108-1473
Mailing Address - Country:US
Mailing Address - Phone:505-266-5557
Mailing Address - Fax:
Practice Address - Street 1:5200 COPPER AVE NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87108-1473
Practice Address - Country:US
Practice Address - Phone:505-266-5557
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-09
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMC-6271235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM=========OtherSLP