Provider Demographics
NPI:1598300410
Name:MUNOZ, NILSY (AS COUNSELING MINIST)
Entity Type:Individual
Prefix:MS
First Name:NILSY
Middle Name:
Last Name:MUNOZ
Suffix:
Gender:F
Credentials:AS COUNSELING MINIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:462 E 35TH ST
Mailing Address - Street 2:
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07504-1714
Mailing Address - Country:US
Mailing Address - Phone:973-855-9147
Mailing Address - Fax:
Practice Address - Street 1:REVELATION UNIVERSITY WELLNESS UNIT
Practice Address - Street 2:307 MONROE ST #4
Practice Address - City:PASSAIC
Practice Address - State:NJ
Practice Address - Zip Code:07055
Practice Address - Country:US
Practice Address - Phone:973-855-9147
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-14
Last Update Date:2019-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRCPE-2040NM8245101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral