Individual
MS. BLAIR W SHEPARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5312 JAGUAR DR, SANTA FE, NM 87507-1827
(505) 820-0262
Mailing address
303 LUNA ST SE, LOS LUNAS, NM 87031-9277
(505) 565-1619
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0119171
NM
101YM0800X
Mental Health Counselor
0121891
NM
Other
Enumeration date
08/05/2008
Last updated
07/29/2009
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