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General NPI Number Information
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NPI Number | 1124395413
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Entity Type | Individual
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Provider Name | JOY NUSSEN LMFT
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Gender | Female
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Dates
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Enumeration Date | 11/30/2011
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Last Update Date | 06/12/2022
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Provider Practice Location Address
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Address Line | 19325 ROBIN CIR APT 72
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City | WEST LINN
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State | OR
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Zip | 97068-2354
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Country | US
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Telephone | 949-422-6355
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Fax |
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Provider Business Mailing Address
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Address Line | 19325 ROBIN CIR APT 72
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City | WEST LINN
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State | OR
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Zip | 97068-2354
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Country | US
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Telephone | 949-422-6355
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | T1997
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFT28654
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License Number State | CA
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