KELLI D SHAW

RUIDOSO, NM
NPI1487714382
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: NM  3439)
Enumeration Date2006-12-11
Last Update Date2007-07-08
Business Address
Ms. KELLI D SHAW LADAC
100 WARRIOR DRIVE
RUIDOSO, NM 88345
Phone number: 505-258-4859
Mailing Address
Ms. KELLI D SHAW LADAC
1400 SUDDERTH DR
RUIDOSO, NM 88345-6103
Phone number: 505-258-4859
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