Individual
ALEXANDRA SHANDALE ESTRADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
504 1ST ST, TULAROSA, NM 88352-2702
(575) 430-5166
Mailing address
504 1ST ST, TULAROSA, NM 88352-2702
(575) 491-0556
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
CTB-2024-0812
NM
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
01/10/2024
Last updated
04/07/2025
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