Doctor Name: | SAREN DEE NELSON |
NPI Number: | 1013051747 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | C0953 |
Business Practice Address: | 1112 Applegate St Philomath, OR - 973709416 |
Business Phone Number: | 5419293719 |
Business Fax Number: | 5419294769 |
Mailing Address: | Po Box 783, PHILOMATH |
State: | OR |
Postal Code: | 973700783 |
Phone Number: | 5419293719 |
Fax Number: | 5419294769 |
NPI Enumeration Date: | 02/16/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | C0953 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OR |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |