Individual
SHANNON T PORCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SW
Contact information
Practice address
1724 CAMINO DEL VALLE SW, ADOBE ACRES ES, ALBUQUERQUE, NM 87105-6003
(505) 877-4799
Mailing address
1724 CAMINO DEL VALLE SW, ADOBE ACRES ES, ALBUQUERQUE, NM 87105-6003
(505) 877-4799
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
M 4769
NM
1041S0200X
School Social Worker
Primary
M 4769
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
17989728
—
NM
Enumeration date
03/02/2007
Last updated
09/11/2025
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