Individual
AMY NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CT, CDCA
Contact information
Practice address
1341 MARKET AVE N, CANTON, OH 44714-2605
(330) 453-8252
Mailing address
1341 MARKET AVE N, CANTON, OH 44714-2605
(330) 453-8252
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
130223
OH
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1500414
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2901131
—
OH
Enumeration date
01/04/2016
Last updated
01/04/2016
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