Individual
DR. JAKOB JAMES NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, PHD
Contact information
Practice address
300 W 19TH TER, KANSAS CITY, MO 64108-2026
(816) 404-6295
(816) 404-6318
Mailing address
4329 CHARLOTTE ST, KANSAS CITY, MO 64110-1548
(816) 531-2264
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2007011137
MO
103T00000X
Psychologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
490205101
—
MO
Enumeration date
02/14/2007
Last updated
11/19/2020
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