Individual
CASEY JAMES SHOOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LSAA
Contact information
Practice address
112 S GOLD AVE, DEMING, NM 88030-3704
(779) 245-4928
Mailing address
112 S GOLD AVE, DEMING, NM 88030-3704
(575) 299-8843
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CTB-2023-0683
NM
Other
Enumeration date
01/23/2024
Last updated
01/23/2024
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