Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | 39001942A | IN |
NPI | 1003090960 |
---|---|
Provider Name | Camishe R Nunley |
First Address | Indianapolis, IN 46256-4649 |
Second Address | Indianapolis, IN 46218-4942 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/12/2007 |
Last Update Date | 21/07/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100270530A | (05) | IN |