Individual
MR. SHAWN DAVID O'CONNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPCC
Contact information
Practice address
184 UNSER BLVD NE, RIO RANCHO, NM 87124-4045
(505) 896-0928
Mailing address
184 UNSER BLVD NE, RIO RANCHO, NM 87124
(505) 896-0928
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YP2500X
Professional Counselor
0165461
NM
101YP2500X
Professional Counselor
Primary
0184251
NM
Other
Enumeration date
01/24/2014
Last updated
05/24/2017
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