Individual
SHELLEY I GOAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
259 BLUEBERRY HILL RD, EL PRADO, NM 87529-7305
(214) 622-7543
Mailing address
259 BLUEBERRY HILL RD, EL PRADO, NM 87529-7305
(214) 622-7543
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CAD0224081
NM
Other
Enumeration date
11/28/2023
Last updated
11/28/2023
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