Individual
LUCRECIA BENALLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
PINION & COTTONWOOD DR. BUILDING 2308, SHIPROCK, NM 87420
(505) 368-1050
(505) 368-1437
Mailing address
607 E APACHE ST, FARMINGTON, NM 87401-6925
(505) 326-2012
(505) 326-2939
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0169541
NM
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CSA0223561
NM
Other
Enumeration date
02/23/2018
Last updated
06/29/2022
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