Provider Demographics
NPI:1619955275
Name:DELAVALLEE, CECELIA A (MD)
Entity Type:Individual
Prefix:DR
First Name:CECELIA
Middle Name:A
Last Name:DELAVALLEE
Suffix:
Gender:F
Credentials:MD
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 PH
Mailing Address - Street 2:CHINLE COMPREHENSIVE HEALTH CARE FACILITY
Mailing Address - City:CHINLE
Mailing Address - State:AZ
Mailing Address - Zip Code:86503-6128
Mailing Address - Country:US
Mailing Address - Phone:928-674-7211
Mailing Address - Fax:
Practice Address - Street 1:HWY 191 & HOSPITAL ROAD
Practice Address - Street 2:
Practice Address - City:CHINLE
Practice Address - State:AZ
Practice Address - Zip Code:86503-3554
Practice Address - Country:US
Practice Address - Phone:928-674-7211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2013-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM96-184207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology