| Doctor Name: | MR. LANCE ROBERT NELSON |
| NPI Number: | 1407029895 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.A. L.P.C.S. |
| License Number: | 4806S |
| Business Practice Address: | 1012 Antioch Woods Dr Weddington, NC - 281047406 |
| Business Phone Number: | 7042817118 |
| Business Fax Number: | |
| Mailing Address: | 1012 Antioch Woods Dr, WEDDINGTON |
| State: | NC |
| Postal Code: | 281047406 |
| Phone Number: | 7042817118 |
| Fax Number: | |
| NPI Enumeration Date: | 04/08/2008 |
| NPI Last Update Date: | 10/10/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 4806S |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |