Benally, Elovonne J.
Benally, Elovonne J. is an individual health care provider with primary practice located at Us Hwy 64 Old High School Road , Shiprock NM 87420. She recently has only one registered license in Behavioral Health & Social Service Providers / School, which is considered as her primary health care specialty. Benally, Elovonne J. can be contacted via phone (505) 368-5163.Contact Information
Primary practice address
Us Hwy 64 Old High School Road
Shiprock NM 87420
Phone: (505) 368-5163
Fax: (505) 368-5502
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / School | 1041S0200X | I-1309 | New Mexico |
Profile Details
| NPI number | 1023142858 |
|---|---|
| LBN Legal business name | Benally, Elovonne J. |
| Credentials | LISW MSW |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 15th, 2007 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1023142858 | NPPES |
| New Mexico | MEDICAID | 53186 |
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