Basic Information
| Provider Information | |||||||||
| NPI: | 1760741888 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NUNEZ | ||||||||
| FirstName: | LOURDES | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | MSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 150 VANCE ST | ||||||||
| Address2: | APT 2 | ||||||||
| City: | NEW BRITAIN | ||||||||
| State: | CT | ||||||||
| PostalCode: | 060521635 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8603574093 | ||||||||
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| Practice Location | |||||||||
| Address1: | 331 WETHERSFIELD AVE | ||||||||
| Address2: | |||||||||
| City: | HARTFORD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 061141420 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8602970573 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/09/2012 | ||||||||
| LastUpdateDate: | 05/09/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.