ELLEN LORRAINE VAN DYKE

TIJERAS, NM
NPI1285405175
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy171M00000X Case Manager/Care Coordinator
Enumeration Date2024-01-10
Last Update Date2024-01-10
Business Address
ELLEN LORRAINE VAN DYKE CCSS
1 CAMINO ORO CT
TIJERAS, NM 87059-7924
Phone number: 706-593-8731
Mailing Address
ELLEN LORRAINE VAN DYKE CCSS
PO BOX 45681
RIO RANCHO, NM 87174-5681
Phone number: 505-226-1960