Healthcare Provider Details

I. General information

NPI: 1609079227
Provider Name (Legal Business Name): ELIZABETH U. DELGADO-TORRES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2007
Last Update Date: 03/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 S DON ROSER DR STE A1
LAS CRUCES NM
88011-4567
US

IV. Provider business mailing address

112 VALLE CALMADO
ANTHONY NM
88021-8745
US

V. Phone/Fax

Practice location:
  • Phone: 575-520-2230
  • Fax:
Mailing address:
  • Phone: 575-520-2230
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: