Individual
MARY JO H SHORTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW
Contact information
Practice address
#1 FOSTER ROAD, RESERVE, NM 87830
(575) 533-6456
(575) 533-6767
Mailing address
PO BOX 710, RESERVE, NM 87830-0710
(575) 533-6456
(575) 533-6767
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I-06997
NM
Other
Enumeration date
08/28/2009
Last updated
01/24/2012
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