Individual
DALE D. DIETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2211 LOMAS BLVD NE, ALBUQUERQUE, NM 87106-2745
(505) 272-8950
(505) 272-3202
Mailing address
4705 MONTGOMERY BLVD NE STE 301, ALBUQUERQUE, NM 87109-1234
(505) 727-4500
(505) 727-4505
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C-09755
NM
1041C0700X
Clinical Social Worker
M-3708
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
NM
Enumeration date
03/29/2007
Last updated
07/21/2022
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