Individual
MR. BRIAN VERNON NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LP, LSP
Contact information
Practice address
3305 CASCO CIR, WAYZATA, MN 55391-9718
(952) 471-7211
(952) 471-7211
Mailing address
3305 CASCO CIR, WAYZATA, MN 55391-9718
(952) 393-6280
(952) 471-7211
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
LP1543
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
224750000
—
MN
Enumeration date
06/29/2006
Last updated
08/07/2008
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