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NPI Code Detail

MEDICARE: MELISSA RAQUEL NUNEZ RBT

MEDICARE: MELISSA RAQUEL NUNEZ RBT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianRBT-19-92618AZ

General Provider Information

NPI Number : 1235783713
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA RAQUEL NUNEZ RBT
Provider Business Mailing Address
First Line : 3060 N RIDGECREST UNIT 197
Second Line :
City : MESA
State : AZ
Zip : 85207-1083
Country : US
Telephone Number : 480-318-1176
Fax Number :
Provider Business Practice Location Address
First Line : 2045 S VINEYARD STE 223
Second Line :
City : MESA
State : AZ
Zip : 85210-6826
Country : US
Telephone Number : 480-656-3530
Fax Number : 480-685-9879
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/01/2019
Last Update Date : 08/01/2019

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Directions to “ MELISSA RAQUEL NUNEZ RBT” Practice Location

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