Individual
GREGORY G NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
607 W 7TH ST, APPLETON, WI 54911-5923
(920) 739-3235
Mailing address
716 MILWAUKEE ST, MENASHA, WI 54952-2236
(920) 915-3886
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
15767-131
WI
Other
Enumeration date
03/25/2014
Last updated
03/25/2014
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