Provider Demographics
NPI:1902156847
Name:MUNOZ-BRUECKMANN, ELIZABETH NMN (MFTI & CPCI)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:NMN
Last Name:MUNOZ-BRUECKMANN
Suffix:
Gender:F
Credentials:MFTI & CPCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 531356
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89053-1356
Mailing Address - Country:US
Mailing Address - Phone:702-364-1993
Mailing Address - Fax:
Practice Address - Street 1:3501 W CHARLESTON BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-1839
Practice Address - Country:US
Practice Address - Phone:702-364-1993
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-18
Last Update Date:2012-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV00315-P101YA0400X
NVCI0058101YM0800X
NVMI0249106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health