| NPI | 1003680836 |
|---|---|
| Doing Business As | SHANNON BALDONADO |
| Entity Type | Organization |
| Authorized Contact | SHANNON NICOLE BALDONADO Licensed Clinical Social Worker 505-596-0366 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2023-11-13 |
| Last Update Date | 2023-11-14 |