Healthcare Provider Details

I. General information

NPI: 1487127361
Provider Name (Legal Business Name): RONNI HAYNIE-NUNEZ LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2019
Last Update Date: 01/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6707 WHITESTONE RD STE 106
BALTIMORE MD
21207-4140
US

IV. Provider business mailing address

6707 WHITESTONE RD STE 106
BALTIMORE MD
21207-4140
US

V. Phone/Fax

Practice location:
  • Phone: 410-265-8737
  • Fax: 410-265-1258
Mailing address:
  • Phone: 410-265-8737
  • Fax: 410-265-1258

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLC8297
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: