Doctor Name: | BRIAN NELSON |
NPI Number: | 1497119325 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | CADC-00329-C |
License Number: | CADC--00329-C |
Business Practice Address: | 35 W 1st St Winnemucca, NV - 894453137 |
Business Phone Number: | 7753040757 |
Business Fax Number: | |
Mailing Address: | 6550 Jason Ct, WINNEMUCCA |
State: | NV |
Postal Code: | 894458296 |
Phone Number: | 7753040757 |
Fax Number: | |
NPI Enumeration Date: | 04/06/2016 |
NPI Last Update Date: | 04/06/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | CADC--00329-C |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NV |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |