Provider Demographics
NPI:1518191352
Name:DELFINO, NANCY ELAINE (LSP)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:ELAINE
Last Name:DELFINO
Suffix:
Gender:F
Credentials:LSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:480 STAGECOACH RD SE
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87124-2329
Mailing Address - Country:US
Mailing Address - Phone:505-227-6928
Mailing Address - Fax:
Practice Address - Street 1:480 STAGECOACH RD SE
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124-2329
Practice Address - Country:US
Practice Address - Phone:505-227-6928
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-07
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool