MEDICARE: ELIZABETH U. DELGADO-TORRES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist

General Provider Information

NPI Number	:	1609079227
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH U. DELGADO-TORRES

Provider Business Mailing Address
First Line	:	112 VALLE CALMADO
Second Line	:
City	:	ANTHONY
State	:	NM
Zip	:	88021-8745
Country	:	US
Telephone Number	:	575-520-2230
Fax Number	:

Provider Business Practice Location Address
First Line	:	1401 S DON ROSER DR STE A1
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88011-4567
Country	:	US
Telephone Number	:	575-520-2230
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/10/2007
Last Update Date	:	03/27/2018

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