Basic Information
| Provider Information | |||||||||
| NPI: | 1104979392 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | COYNE-SCHMIDT | ||||||||
| FirstName: | DEENA | ||||||||
| MiddleName: | F. | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | M.S. CCC-SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1350 HILLRISE CIR | ||||||||
| Address2: | |||||||||
| City: | LAS CRUCES | ||||||||
| State: | NM | ||||||||
| PostalCode: | 880114759 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5056227354 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1350 HILLRISE CIR | ||||||||
| Address2: | |||||||||
| City: | LAS CRUCES | ||||||||
| State: | NM | ||||||||
| PostalCode: | 880114759 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5755229500 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/19/2007 | ||||||||
| LastUpdateDate: | 05/01/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 893 | NM | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
ID Information
| ID | Type | State | Issuer | Description | B3993 | 05 | NM | MEDICAID |