Individual
BLANCA ELIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
872 S CAMINO DEL PUEBLO, BERNALILLO, NM 87004-5927
(505) 867-2383
(505) 867-7293
Mailing address
2903 JEFFERSON ST NE, ALBUQUERQUE, NM 87110-3007
(505) 867-2383
(505) 867-7293
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
T-0109681
NM
Other
Enumeration date
10/25/2006
Last updated
05/02/2008
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