Provider Demographics
NPI:1891122891
Name:NUNEZ, AMY
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:NUNEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5160 S EASTERN AVE STE C
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-2300
Mailing Address - Country:US
Mailing Address - Phone:702-738-2401
Mailing Address - Fax:702-547-9974
Practice Address - Street 1:5160 S EASTERN AVE STE C
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-2300
Practice Address - Country:US
Practice Address - Phone:702-738-2401
Practice Address - Fax:702-547-9974
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-04
Last Update Date:2013-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst