Individual
SHASTA SKYLER RAEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1100 W. 21ST, CLOVIS, NM 88101
(575) 742-2620
Mailing address
1100 W. 21ST, CLOVIS, NM 88101
(575) 769-2345
(575) 769-9031
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
0118461
NM
101YM0800X
Mental Health Counselor
Primary
0134861
NM
Other
Enumeration date
12/22/2008
Last updated
03/25/2015
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