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Individual

MS. SHEREL E WHITED

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
501 S ABILENE AVE, PORTALES, NM 88130-6380
(505) 359-3707
Mailing address
8155 NEW MEXICO 206, PORTALES, NM 88130-9757
(505) 356-8265

Taxonomy

Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
M-04675
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01376713
NM
Enumeration date
01/19/2007
Last updated
07/08/2007
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