Bettolivaughan, Elena
Bettolivaughan, Elena is an individual health care provider with primary practice located at 1325 Wyoming Blvd Ne Pmg Kaseman Behavioral Medicine, Albuquerque NM 87112-5046. She recently has only one registered license in Behavioral Health & Social Service Providers / Psychoanalysis, which is considered as her primary health care specialty. Bettolivaughan, Elena can be contacted via phone (505) 291-2536.Contact Information
Primary practice address
1325 Wyoming Blvd Ne Pmg Kaseman Behavioral Medicine
Albuquerque NM 87112-5046
Phone: (505) 291-2536
Fax: (505) 291-5327
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Psychoanalysis | 103TP0814X | 644 | New Mexico |
Profile Details
NPI number | 1083730980 |
---|---|
LBN Legal business name | Bettolivaughan, Elena |
Credentials | PHD |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Mar 22nd, 2007 |
Last updated | Dec 14th, 2009 - about 15 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 | 1083730980 | NPPES |
New Mexico | MEDICAID | 000K2674 |
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