Individual
ALICIA RENE SHIVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
2632 PENNSYLVANIA ST NE STE E, ALBUQUERQUE, NM 87110-3650
(505) 242-4400
Mailing address
1725 LAFAYETTE DR NE, ALBUQUERQUE, NM 87106-1003
(505) 697-8344
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0186381
NM
101YM0800X
Mental Health Counselor
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Other
Enumeration date
05/31/2017
Last updated
05/31/2017
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