Provider Demographics
NPI:1265257117
Name:DASHWOOD, NANCY PAGE
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:PAGE
Last Name:DASHWOOD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:616 SILVER SADDLE RD SE
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87124-2324
Mailing Address - Country:US
Mailing Address - Phone:507-327-9368
Mailing Address - Fax:
Practice Address - Street 1:616 SILVER SADDLE RD SE
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124-2324
Practice Address - Country:US
Practice Address - Phone:507-327-9368
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-16
Last Update Date:2024-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician