Individual
GINGER SHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPSW CSSS
Contact information
Practice address
400 GOLD AVE SW STE 1300, ALBUQUERQUE, NM 87102-3274
(505) 738-5908
Mailing address
303 N ALAMEDA BLVD, LAS CRUCES, NM 88005-2590
(575) 523-0111
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
11/19/2019
Last updated
04/10/2024
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