Doctor Name: | JOHN C NUSS |
NPI Number: | 1093986309 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | LASAC-13085 |
Business Practice Address: | 564 N Idaho Rd Suite # 6 Apache Junction, AZ - 852194002 |
Business Phone Number: | 4802885328 |
Business Fax Number: | 4802885339 |
Mailing Address: | Po Box 3160, APACHE JUNCTION |
State: | AZ |
Postal Code: | 852173160 |
Phone Number: | 4802885328 |
Fax Number: | 4802885339 |
NPI Enumeration Date: | 03/13/2008 |
NPI Last Update Date: | 03/13/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | LASAC-13085 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |