Individual
MS. ELAINE DELVALLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW
Contact information
Practice address
1807 SECOND ST SUITE 44A, SANTA FE, NM 87505
(505) 988-1723
Mailing address
147 CALLE OJO FELIZ, UNIT O, SANTA FE, NM 87505
(505) 988-1723
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I2715
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
L2715
SOCIAL WORK
NM
01
—
NM00JC15
BLUE CROSS BLUE SHIELD
NM
Enumeration date
10/11/2006
Last updated
07/08/2007
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