Individual
DR. DIANE LUTZ DICUBELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
8200 MOUNTAIN RD NE, ALBUQUERQUE, NM 87110-7843
(505) 830-6500
(505) 830-6527
Mailing address
7010 PHOENIX AVE NE APT 214, ALBUQUERQUE, NM 87110-3559
(505) 720-6869
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I-06312
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02322374
—
NM
Enumeration date
08/01/2006
Last updated
10/08/2018
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