Provider Demographics
NPI:1043378771
Name:HANDMAKER, NANCY (PHD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:
Last Name:HANDMAKER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3949 CORRALES RD
Mailing Address - Street 2:SUITE 240
Mailing Address - City:CORRALES
Mailing Address - State:NM
Mailing Address - Zip Code:87048-9348
Mailing Address - Country:US
Mailing Address - Phone:505-897-7755
Mailing Address - Fax:505-897-7799
Practice Address - Street 1:3949 CORRALES ROAD
Practice Address - Street 2:SUITE 240
Practice Address - City:CORRALES
Practice Address - State:NM
Practice Address - Zip Code:87048
Practice Address - Country:US
Practice Address - Phone:505-897-7755
Practice Address - Fax:505-897-7799
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2009-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM718103TA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)