Organization
MICHAEL JAN NELSON PHD
Active
Other names
Clinical Services
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JULIE A SIGLER EDMUNDSON LPC (ADMINISTRATOR)
(715) 712-1370
Entity
Organization
Contact information
Practice address
420 1ST AVE S, WISCONSIN RAPIDS, WI 54495
(715) 424-3400
(715) 424-3441
Mailing address
PO BOX 1535, WISCONSIN RAPIDS, WI 54495-1535
(715) 424-3400
(715) 424-3441
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
—
—
251S00000X
Community/Behavioral Health Agency
Primary
1298
WI
Other
Enumeration date
06/17/2008
Last updated
08/29/2019
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