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1629514633
TRACY SHAW
RIO RANCHO, NM
NPI
1629514633
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: NM 0141901)
Enumeration Date
2017-01-13
Last Update Date
2017-01-13
Business Address
-- TRACY SHAW LADAC
4100 BARBARA LOOP SE
RIO RANCHO, NM 87124-1000
Phone number: 505-702-8547
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Mailing Address
-- TRACY SHAW LADAC
4100 BARBARA LOOP SE
RIO RANCHO, NM 87124-1000
Phone number: 505-702-8547
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