Provider Demographics
NPI:1033495361
Name:DUNNAHOO, NANCY L (LMHC, LADAC)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:L
Last Name:DUNNAHOO
Suffix:
Gender:F
Credentials:LMHC, LADAC
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:L
Other - Last Name:BAILEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1105 MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:ARTESIA
Mailing Address - State:NM
Mailing Address - Zip Code:88210-1189
Mailing Address - Country:US
Mailing Address - Phone:575-746-9848
Mailing Address - Fax:575-746-9840
Practice Address - Street 1:1105 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:ARTESIA
Practice Address - State:NM
Practice Address - Zip Code:88210-1189
Practice Address - Country:US
Practice Address - Phone:575-746-9848
Practice Address - Fax:575-746-9840
Is Sole Proprietor?:No
Enumeration Date:2011-11-01
Last Update Date:2019-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0136171101Y00000X
NMT-0150871101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor