Provider Demographics
NPI:1558688655
Name:BECKLUND, DANELLE L (MA)
Entity Type:Individual
Prefix:MS
First Name:DANELLE
Middle Name:L
Last Name:BECKLUND
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 ADAMS PL SE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87108-3411
Mailing Address - Country:US
Mailing Address - Phone:505-321-4121
Mailing Address - Fax:
Practice Address - Street 1:801 ADAMS PL SE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87108-3411
Practice Address - Country:US
Practice Address - Phone:505-321-4121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-28
Last Update Date:2010-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM005906101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health