Dr Osvelia G Deeds Llc | |
5203 Juan Tabo Blvd Ne Ste 2b Albuquerque NM 87111-2691 | |
(505) 850-5314 | |
(505) 221-5710 |
Full Name | Dr Osvelia G Deeds Llc |
---|---|
Speciality | Psychologist |
Location | 5203 Juan Tabo Blvd Ne Ste 2b, Albuquerque, New Mexico |
Authorized Official Name and Position | Dawn Halfacre (CREDENTIALING SPECIALIST) |
Authorized Official Contact | 5053525269 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Dr Osvelia G Deeds Llc 1542 Rosalba St Ne Albuquerque NM 87112-6552 Ph: (505) 850-5314 | Dr Osvelia G Deeds Llc 5203 Juan Tabo Blvd Ne Ste 2b Albuquerque NM 87111-2691 Ph: (505) 850-5314 |
NPI Number | 1912275124 |
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Provider Enumeration Date | 12/02/2011 |
Last Update Date | 12/02/2011 |
Medicare PECOS PAC ID | 5799952578 |
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Medicare Enrollment ID | O20120119000111 |
Identifier | Type | State | Issuer |
---|---|---|---|
1912275124 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103T00000X | Psychologist | 1095 (New Mexico) | Primary |
Provider Name | Osvelia G Deeds |
---|---|
Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1306171723 PECOS PAC ID: 2264562784 Enrollment ID: I20100610000213 |
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