Doctor Name: | KIMBERLY NELSON |
NPI Number: | 1346602422 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CADC |
License Number: | 11093 |
Business Practice Address: | 1011 10th St Onawa, IA - 510401614 |
Business Phone Number: | 7124239098 |
Business Fax Number: | 7124239604 |
Mailing Address: | 1011 10th St, ONAWA |
State: | IA |
Postal Code: | 510401614 |
Phone Number: | 7124239098 |
Fax Number: | 7124239604 |
NPI Enumeration Date: | 03/28/2016 |
NPI Last Update Date: | 03/28/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 11093 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |