Individual
NICOLE M IANNONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSAA
Contact information
Practice address
1141 MALL DR STE E, LAS CRUCES, NM 88011-8194
(575) 522-0660
Mailing address
1141 MALL DR STE E, LAS CRUCES, NM 88011-8194
(575) 522-0660
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CTB-2023-0834
NM
Other
Enumeration date
11/20/2023
Last updated
11/20/2023
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