Individual
CAROL DIECKMANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
2702 PLACITA CHUECO, SANTA FE, NM 87505-5254
(505) 603-8138
Mailing address
1092 EARLY ST, SUITE #2, SANTA FE, NM 87505-1662
(505) 603-8138
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
0113631
NM
101YP2500X
Professional Counselor
Primary
0136271
NM
Other
Enumeration date
08/24/2009
Last updated
06/08/2011
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