Individual
KRISTENE C. SHERYL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADAC
Contact information
Practice address
332 E. MOTEL DRIVE, LORDSBURG, NM 88045
(575) 542-3304
(575) 542-3305
Mailing address
1320 S. SOLANO, LAS CRUCES, NM 88001
(575) 527-7900
(575) 571-4872
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0110461
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
18677037
—
NM
05
—
89129229
—
NM
Enumeration date
02/29/2008
Last updated
03/29/2014
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