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Individual

MARY E SHACKELFORD-MARTINEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA, CCC-SLP

Contact information

Practice address
186A RIM ROAD, ARROYO SECO, NM 87514
(575) 776-3267
Mailing address
PO BOX 1796, EL PRADO, NM 87529-1796
(575) 776-3267

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3322
NM

Other

Enumeration date
01/15/2010
Last updated
01/15/2010
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