Provider Demographics
NPI:1164481750
Name:NUNEZ, ROSE MARIE (NCC, LPC)
Entity Type:Individual
Prefix:
First Name:ROSE
Middle Name:MARIE
Last Name:NUNEZ
Suffix:
Gender:F
Credentials:NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22320 E MERLOT ST
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85242-9034
Mailing Address - Country:US
Mailing Address - Phone:602-615-7911
Mailing Address - Fax:
Practice Address - Street 1:22320 E MERLOT ST
Practice Address - Street 2:
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85242-9034
Practice Address - Country:US
Practice Address - Phone:602-615-7911
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ10952101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional