Individual
MR. JON GARY NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
4992 CACTUS PL, PRESCOTT, AZ 86301-5845
(602) 628-6190
Mailing address
4992 CACTUS PL, PRESCOTT, AZ 86301-5845
(602) 628-6190
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPC-16805
AZ
Other
Enumeration date
10/03/2017
Last updated
10/03/2017
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