Provider Demographics
NPI:1275331431
Name:NUNO, ABRAHAM (MS, LAC)
Entity type:Individual
Prefix:
First Name:ABRAHAM
Middle Name:
Last Name:NUNO
Suffix:
Gender:
Credentials:MS, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1780 N SAN SIMON DR
Mailing Address - Street 2:
Mailing Address - City:NOGALES
Mailing Address - State:AZ
Mailing Address - Zip Code:85621-4105
Mailing Address - Country:US
Mailing Address - Phone:520-278-0544
Mailing Address - Fax:
Practice Address - Street 1:1780 N SAN SIMON DR
Practice Address - Street 2:
Practice Address - City:NOGALES
Practice Address - State:AZ
Practice Address - Zip Code:85621-4105
Practice Address - Country:US
Practice Address - Phone:520-278-0544
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-04
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLAC-22269101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor