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Individual

DR. IBIS DANITZIA NUNEZ-SANTIAGO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
119 BOONE RIDGE DR, STE 201, JOHNSON CITY, TN 37615-4998
(423) 282-1480
(423) 928-1353
Mailing address
PO BOX 2034, SYLVA, NC 28779-2034
(828) 586-8160
(828) 586-8209

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1174
SC
103T00000X
Psychologist
3389
TN
103T00000X
Psychologist
4066
NC

Other

Enumeration date
04/02/2007
Last updated
12/07/2016
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