Organization
TAKE ACTION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA A NANDINO MA LPCC (THERAPIST)
(505) 832-9135
Entity
Organization
Contact information
Practice address
704 CENTRAL AVENUE WEST SUITE B, MORIARTY, NM 87035
(505) 901-9143
Mailing address
PO BOX 85, 704 US RT 66 SUITE B, MORIARTY, NM 87035-0085
(505) 832-9135
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0118471
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
51305887
—
NM
Enumeration date
01/26/2017
Last updated
05/10/2017
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