| Doctor Name: | ELOVONNE J. BENALLY |
| NPI Number: | 1023142858 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LISW MSW |
| License Number: | I-1309 |
| Business Practice Address: | Us Hwy 64 Old High School Road Shiprock, NM - 87420 |
| Business Phone Number: | 5053685163 |
| Business Fax Number: | 5053685502 |
| Mailing Address: | 30 Cr 6570 Nbu, #62a KIRTLAND |
| State: | NM |
| Postal Code: | 87417 |
| Phone Number: | 5055985269 |
| Fax Number: | |
| NPI Enumeration Date: | 03/15/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041S0200X |
| License Number: | I-1309 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NM |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | School |
| Taxonomy Definition: | |