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Individual

JORDAN SHOEMAKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
944 MOUNTAIN LAUREL CIR SE UNIT B, ALBUQUERQUE, NM 87116-1251
(907) 201-7761
Mailing address
944 MOUNTAIN LAUREL CIR SE UNIT B, ALBUQUERQUE, NM 87116-1251
(907) 201-7761

Taxonomy

Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
106S00000X
NM
Enumeration date
08/12/2021
Last updated
08/12/2021
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