Individual
MS. SHAWNA AVILA KIBUTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LMHC
Contact information
Practice address
8205 SPAIN RD NE STE 106, ALBUQUERQUE, NM 87109-3155
(505) 856-0300
(505) 856-7946
Mailing address
8205 SPAIN RD NE STE 106, ALBUQUERQUE, NM 87109-3155
(505) 856-0300
(505) 856-7946
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CTL0202841
NM
104100000X
Social Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
N3938
—
NM
Enumeration date
06/07/2016
Last updated
10/08/2019
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