Individual
MELISSA ANN NANDINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
1801 ROUTE 66,, MORIARTY, NM 87035
(505) 705-0756
Mailing address
PO BOX 1007, ESTANCIA, NM 87016-1007
(505) 705-0756
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
0118471
NM
101YP2500X
Professional Counselor
Primary
0139141
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
44842
—
NM
Enumeration date
07/19/2010
Last updated
07/20/2011
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