Individual
PROF. IVAN LOUIS NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LADC,CPP
Contact information
Practice address
34 MORELAND AVE E, SAINT PAUL, MN 55118-2444
(612) 306-3416
Mailing address
9333 NESBITT RD, BLOOMINGTON, MN 55437-1916
(612) 306-3416
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
304554
MN
Other
Enumeration date
07/14/2021
Last updated
07/14/2021
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