Individual
DANIELLE SHANEEN BENALLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
5840 FORTUNA DR, FARMINGTON, NM 87402-8210
(505) 324-9840
Mailing address
5840 FORTUNA DR, FARMINGTON, NM 87402-8210
(505) 860-4844
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SWB-2023-1089
NM
1041S0200X
School Social Worker
401722
NM
Other
Enumeration date
01/05/2021
Last updated
11/08/2023
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