Doctor Name: | ELISE HENSLEY |
NPI Number: | 1194736223 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | L.I.S.W. |
License Number: | I-04788 |
Business Practice Address: | 02 Hormiga Court Los Lunas, NM - 870313319 |
Business Phone Number: | 5052708778 |
Business Fax Number: | 5058662282 |
Mailing Address: | P. O. Box 3319, LOS LUNAS |
State: | NM |
Postal Code: | 870313319 |
Phone Number: | 5052708778 |
Fax Number: | 5058662282 |
NPI Enumeration Date: | 08/11/2006 |
NPI Last Update Date: | 12/13/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | I-04788 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NM |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |