Organization
ELLEN J SHABSHAI FOX, LISW
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ELLEN J SHABSHAI FOX 5056994312 (DIRECTOR)
(505) 699-4312
Entity
Organization
Contact information
Practice address
2400 CALLE AMELIA, SANTA FE, NM 87505-6280
(505) 699-4312
Mailing address
2400 CALLE AMELIA, SANTA FE, NM 87505-6280
(505) 699-4312
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I06240
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000598
—
NM
Enumeration date
03/01/2010
Last updated
03/01/2010
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