Individual
MARK NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7784 INNOVATION PARK DR, BATON ROUGE, LA 70820-7006
(225) 620-6703
Mailing address
345 E STATE ST APT C, BATON ROUGE, LA 70802-6925
(504) 218-9502
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/22/2021
Last updated
07/22/2021
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