Individual
SHUNJIRO CLIFFORD KIDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
901 AVENIDA DE LAS CAMPANAS, SANTA FE, NM 87507-5369
(505) 467-1800
Mailing address
1853 MANN ST APT 2, SANTA FE, NM 87505-3433
(802) 338-0822
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
CF7440
NM
Other
Enumeration date
08/23/2021
Last updated
08/23/2021
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