Provider Demographics
NPI:1093011405
Name:NARANJO, DUSTY DAWN (LMHC)
Entity Type:Individual
Prefix:
First Name:DUSTY
Middle Name:DAWN
Last Name:NARANJO
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 KEE RD
Mailing Address - Street 2:
Mailing Address - City:ESPANOLA
Mailing Address - State:NM
Mailing Address - Zip Code:87532-8907
Mailing Address - Country:US
Mailing Address - Phone:505-692-6315
Mailing Address - Fax:505-692-6341
Practice Address - Street 1:1 KEE RD
Practice Address - Street 2:
Practice Address - City:ESPANOLA
Practice Address - State:NM
Practice Address - Zip Code:87532-8907
Practice Address - Country:US
Practice Address - Phone:150-569-6315
Practice Address - Fax:505-692-6341
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-02
Last Update Date:2011-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0111181101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health