Individual
SHELBY LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1596 PACHECO ST STE 201, SANTA FE, NM 87505-3960
(505) 717-1155
Mailing address
6001 WHITEMAN DR NW, ALBUQUERQUE, NM 87120-2196
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
08/12/2021
Last updated
08/12/2021
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