Individual
SHANNON GOINS-BLAIR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CLT-LANA, AFMC, LMT
Contact information
Practice address
6800 MONTGOMERY BLVD NE STE G, ALBUQUERQUE, NM 87109-1425
(505) 554-1855
Mailing address
20 CAMINO YRISARRI, TIJERAS, NM 87059-6300
(505) 554-5185
Taxonomy
Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
Primary
FUNCTIONALMEDICINE
—
225700000X
Massage Therapist
8941
NM
246Z00000X
Other Specialist/Technologist
CLT
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8941
STATE OF NEW MEXICO MASSAGE THERAPY BOARD
NM
01
—
AFM-CERTIFIED
APPLIED-FUNCTIONAL-MEDICINE-CERTIFIED
NM
01
—
CLT
KLOSE TRAINING - CERTIFIED LYMPHEDEMA THERAPIST
—
01
—
FMHC
FUNCTIONAL MEDICINE HEALTH COACH
—
01
—
LANA
LYMPHOLOGY ASSOCIATION OF NORTH AMERICA
—
Enumeration date
07/27/2017
Last updated
11/21/2025
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