Bettolivaughan, Elena

Bettolivaughan, Elena is an individual health care provider with primary practice located at 1325 Wyoming Blvd Ne Pmg Kaseman Behavioral Medicine, Albuquerque NM 87112-5046. She recently has only one registered license in Behavioral Health & Social Service Providers / Psychoanalysis, which is considered as her primary health care specialty. Bettolivaughan, Elena can be contacted via phone (505) 291-2536.

Contact Information

Primary practice address
1325 Wyoming Blvd Ne Pmg Kaseman Behavioral Medicine Albuquerque NM 87112-5046
Phone: (505) 291-2536
Fax: (505) 291-5327
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychoanalysis 103TP0814X 644 New Mexico

Profile Details

NPI number 1083730980
LBN Legal business name Bettolivaughan, Elena
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 22nd, 2007
Last updated Dec 14th, 2009 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1083730980 NPPES
New Mexico MEDICAID 000K2674

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