Individual
ALFRED B BENALLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
129 MEDICINE HORSE DRIVE, TOHAJIILEE, NM 87026
(505) 908-2307
Mailing address
PO BOX 3338, CANONCITO, NM 87026-3338
(505) 908-2517
(505) 908-2572
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
3854
NM
Other
Enumeration date
11/11/2010
Last updated
03/11/2020
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