Individual
ELEANA MAIA BUTLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
14 ROAD 4625, BLANCO, NM 87412-9743
(505) 632-2138
(505) 326-2557
Mailing address
14 ROAD 4625, BLANCO, NM 87412-9743
(505) 632-2138
(505) 326-2557
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A0850
—
NM
Enumeration date
01/23/2007
Last updated
07/09/2007
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