Provider Demographics
NPI:1609964824
Name:DI CESARE-PANNUTTI, SAHNTA LEE (LPAT)
Entity Type:Individual
Prefix:
First Name:SAHNTA
Middle Name:LEE
Last Name:DI CESARE-PANNUTTI
Suffix:
Gender:F
Credentials:LPAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7027 MONTGOMERY BLVD NE
Mailing Address - Street 2:STE F
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-1589
Mailing Address - Country:US
Mailing Address - Phone:505-880-0100
Mailing Address - Fax:505-880-0102
Practice Address - Street 1:23 CALLE BLANCA
Practice Address - Street 2:
Practice Address - City:CORRALES
Practice Address - State:NM
Practice Address - Zip Code:87048-7825
Practice Address - Country:US
Practice Address - Phone:505-264-3933
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0166591106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist