Individual
DR. LYNN ELLEN NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3330 OLD GLENVIEW RD, SUITE 15, WILMETTE, IL 60091-2963
(847) 204-1557
Mailing address
3330 OLD GLENVIEW RD, SUITE 15, WILMETTE, IL 60091-2963
(847) 204-1557
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071004944
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1093795106
NPPES
IL
Enumeration date
12/07/2009
Last updated
12/07/2009
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