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1083730980
ELENA BETTOLIVAUGHAN
ALBUQUERQUE, NM
NPI
1083730980
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
103TP0814X Psychologist, Psychoanalysis
(Licence: NM 644)
Enumeration Date
2007-03-22
Last Update Date
2009-12-14
Business Address
ELENA BETTOLIVAUGHAN PhD
1325 WYOMING BLVD NE PMG KASEMAN BEHAVIORAL MEDICINE
ALBUQUERQUE, NM 87112-5046
Phone number: 505-291-2536
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Mailing Address
ELENA BETTOLIVAUGHAN PhD
PO BOX 26666 PHS PROVIDER ENROLLMENT
ALBUQUERQUE, NM 87125-6666
Phone number: 505-923-5356
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