Individual
DIANE LECLAIR SHAFER DEKKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
320 OSUNA RD NE, SUITE H, ALBUQUERQUE, NM 87107-5952
(505) 345-2778
(505) 345-2878
Mailing address
534 BLACK BEAR RD NE, ALBUQUERQUE, NM 87122-1816
(505) 280-4295
(505) 856-6764
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
379
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000N7208
—
NM
Enumeration date
11/17/2006
Last updated
07/08/2007
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