Provider Demographics
NPI:1144891466
Name:TORELLO, JEZZETTE A (CSW)
Entity type:Individual
Prefix:
First Name:JEZZETTE
Middle Name:A
Last Name:TORELLO
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:JEZZETTE
Other - Middle Name:A
Other - Last Name:TORELLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CSW
Mailing Address - Street 1:PO BOX 392
Mailing Address - Street 2:
Mailing Address - City:TUCUMCARI
Mailing Address - State:NM
Mailing Address - Zip Code:88401-0392
Mailing Address - Country:US
Mailing Address - Phone:575-461-9907
Mailing Address - Fax:575-461-9867
Practice Address - Street 1:419 S 2ND ST
Practice Address - Street 2:
Practice Address - City:TUCUMCARI
Practice Address - State:NM
Practice Address - Zip Code:88401-2859
Practice Address - Country:US
Practice Address - Phone:575-461-9907
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-07
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor