| Doctor Name: | DR. RONALD J NELSON |
| NPI Number: | 1104977990 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | ED.D. |
| License Number: | |
| Business Practice Address: | 480 N. Bisbee Ave Willcox, AZ - 85643 |
| Business Phone Number: | 5203844211 |
| Business Fax Number: | 5208685254 |
| Mailing Address: | Po Box 2965, FLORENCE |
| State: | AZ |
| Postal Code: | 852322965 |
| Phone Number: | 5208685254 |
| Fax Number: | 5208685254 |
| NPI Enumeration Date: | 01/16/2007 |
| NPI Last Update Date: | 07/26/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TS0200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | School |
| Taxonomy Definition: | |