Provider Demographics
NPI:1386202778
Name:DELAGARZA, APRIL J
Entity Type:Individual
Prefix:
First Name:APRIL
Middle Name:J
Last Name:DELAGARZA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 233
Mailing Address - Street 2:
Mailing Address - City:LORDSBURG
Mailing Address - State:NM
Mailing Address - Zip Code:88045-0233
Mailing Address - Country:US
Mailing Address - Phone:575-313-6578
Mailing Address - Fax:
Practice Address - Street 1:521 E 10TH ST
Practice Address - Street 2:
Practice Address - City:LORDSBURG
Practice Address - State:NM
Practice Address - Zip Code:88045-2343
Practice Address - Country:US
Practice Address - Phone:575-313-6578
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-31
Last Update Date:2019-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMYIF905023926Medicaid