Individual
MRS. LISA A NUNNALLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, LCDC
Contact information
Practice address
5373 GRUBER RD, BUILDING C8837, FORT BRAGG, NC 28310-0001
(910) 908-6011
Mailing address
5373 GRUBER RD, BUILDING C8837, FORT BRAGG, NC 28310-0001
(910) 908-6011
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
10645
TX
101YP2500X
Professional Counselor
62885
TX
Other
Enumeration date
01/21/2010
Last updated
01/02/2015
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