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Individual

SHAWNA M SHARP

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN LPCC

Contact information

Practice address
8300 CONSTITUTION AVE NE, PMG EMERGENCY MEDICINE, ALBUQUERQUE, NM 87110-7613
(505) 291-2122
(505) 291-2979
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-6770
(505) 923-5354

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0164961
NM
101YP2500X
Professional Counselor
0164961
NM

Other

Enumeration date
08/14/2014
Last updated
08/12/2015
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