Icon Innovations LLC
NPI #1760540512 in Albuquerque, New Mexico
Provider Information
- NPI Number
- 1760540512
- Entity Type
- Organization
- Organization Name
- Icon Innovations LLC
- Primary Specialty
- Speech-Language Pathologist
- Enumeration Date
- Dec 5, 2006
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 9620 GIDDINGS AVE NE
- City
- Albuquerque
- State
- New Mexico
- ZIP Code
- 87109-6413
- Phone
- (505) 856-0284
Authorized Official
- Name
- MRS. DANA LYNN REILLY, M.S., CCC-SLP
- Title
- MANAGING MEMBER
- Phone
- (505) 856-0284
Specialties & Taxonomy Codes
| Specialty |
|---|
| Speech-Language Pathologist |
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