Doctor Name: | SUSAN K NARDUCCIE |
NPI Number: | 1003031758 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMHP |
License Number: | 767 |
Business Practice Address: | 600 Fremont St Shenandoah, IA - 516011539 |
Business Phone Number: | 7122465506 |
Business Fax Number: | 7122465506 |
Mailing Address: | Po Box 641130, OMAHA |
State: | NE |
Postal Code: | 681647130 |
Phone Number: | 4025722907 |
Fax Number: | 4025723544 |
NPI Enumeration Date: | 04/16/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 767 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |