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Individual

MATTHEW SHANCE ALVARADO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1111 W FIR ST, PORTALES, NM 88130-5826
(505) 356-5221
Mailing address
1111 W FIR ST, PORTALES, NM 88130-5826
(505) 356-5221

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
T - 0102691
NM

Other

Enumeration date
09/28/2007
Last updated
09/28/2007
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