Individual
MRS. SHALAN COSTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
619 N ALAMEDA BLVD, LAS CRUCES, NM 88005-2130
(575) 405-7146
Mailing address
2745 TIERRA GIJON PL, EL PASO, TX 79938-2224
(910) 703-2900
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
CAMF0220641
NM
Other
Enumeration date
10/18/2021
Last updated
10/18/2021
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