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Individual

MRS. SHALADA CRISTAL CREECY-GUTIERREZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
5555 ZUNI RD SE STE 11, ALBUQUERQUE, NM 87108-2935
(505) 777-3002
Mailing address
PO BOX 740018, ATLANTA, GA 30374-0018
(113) 759-7550
(312) 929-0373

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
X-10293
NM
1041C0700X
Clinical Social Worker
Primary
C-11808
NM

Other

Enumeration date
11/18/2017
Last updated
11/23/2022
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