Healthcare Provider Details

I. General information

NPI: 1639069107
Provider Name (Legal Business Name): HANNAH RUTH NUNEZ LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2025
Last Update Date: 07/07/2025
Certification Date: 07/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

824 S SAN FRANCISCO ST
FLAGSTAFF AZ
86011-0001
US

IV. Provider business mailing address

824 S SAN FRANCISCO ST
FLAGSTAFF AZ
86011-0001
US

V. Phone/Fax

Practice location:
  • Phone: 928-523-2131
  • Fax:
Mailing address:
  • Phone: 928-523-2131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC-16162
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: