Provider Demographics
NPI:1972839439
Name:NUNEZ, JEANNIE CHANDLER (PSYD)
Entity type:Individual
Prefix:DR
First Name:JEANNIE
Middle Name:CHANDLER
Last Name:NUNEZ
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15861 SURREY CIR
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33331-2570
Mailing Address - Country:US
Mailing Address - Phone:954-374-4747
Mailing Address - Fax:877-309-7271
Practice Address - Street 1:1941 NW 150TH AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33028-2874
Practice Address - Country:US
Practice Address - Phone:954-374-4747
Practice Address - Fax:877-309-7271
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-19
Last Update Date:2013-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY 7981103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist