Individual
MRS. BRANDY L. SHINNICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
01 SAGEBRUSH STREET, ISLETA, NM 87022
(505) 869-5475
(505) 869-4881
Mailing address
PO BOX 640, ISLETA, NM 87022-0640
(505) 869-5475
(505) 869-4881
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CSA0203541
NM
Other
Enumeration date
05/15/2019
Last updated
05/15/2019
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