Organization
DR OSVELIA G DEEDS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAWN HALFACRE (CREDENTIALING SPECIALIST)
(505) 352-5269
Entity
Organization
Contact information
Practice address
5203 JUAN TABO BLVD NE STE 2B, ALBUQUERQUE, NM 87111-2691
(505) 850-5314
(505) 221-5710
Mailing address
1542 ROSALBA ST NE, ALBUQUERQUE, NM 87112-6552
(505) 850-5314
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1095
NM
Other
Enumeration date
12/02/2011
Last updated
12/02/2011
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