Individual
JUANITA SHULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
950 W AZTEC AVE, GALLUP, NM 87301-6666
(866) 273-2451
(866) 608-5560
Mailing address
1408 8TH ST, ALAMOGORDO, NM 88310-5115
(866) 273-2451
(866) 608-5560
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
01/06/2021
Last updated
09/24/2025
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