Individual
MELISSA BENVEGNO-IMUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
5601 DOMINGO RD NE, ALBUQUERQUE, NM 87108-1610
(505) 268-5295
Mailing address
5601 DOMINGO RD NE, ALBUQUERQUE, NM 87108-1610
(505) 268-5295
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
01-874723-000
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
B9311
—
NM
Enumeration date
01/11/2017
Last updated
01/11/2017
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