Healthcare Provider Details
I. General information
NPI: 1437373719
Provider Name (Legal Business Name): AURELIA BEGAY-HARLAN LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 04/11/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
HIGHWAY 371 JUNCTION ROUTE 9
CROWNPOINT NM
87313-0358
US
IV. Provider business mailing address
PO BOX 358
CROWNPOINT NM
87313-0358
US
V. Phone/Fax
- Phone: 505-786-5291
- Fax: 505-786-6440
- Phone: 505-786-5291
- Fax: 505-786-6440
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | M-06035 |
| License Number State | NM |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: