Individual
SHANTELL MOYERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
1001 EAST SUMNER AVE, FORT SUMNER, NM 88119-0387
(575) 355-7734
Mailing address
PO BOX 847, PORTALES, NM 88130-0847
(575) 562-4458
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C-11778
NM
Other
Enumeration date
12/04/2017
Last updated
11/06/2025
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