Individual
MS. COLLISE BELANSKY LEVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
2211 LOMAS BLVD NE, BOX 200, ALBUQUERQUE, NM 87106-2745
(505) 272-4763
Mailing address
9201 WALLACE AVE NE, ALBUQUERQUE, NM 87109-6451
(505) 823-9310
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I-2533
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
890285
PROVIDER BILLING NUMBER
NM
Enumeration date
12/11/2006
Last updated
07/08/2007
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