Individual
DIANE W NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
331 SE 2ND ST, PENDLETON, OR 97801-2224
(541) 276-6207
(541) 276-4628
Mailing address
PO BOX X, ONTARIO, OR 97914-0078
(541) 889-9167
(541) 889-7873
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
L3959
OR
Other
Enumeration date
02/20/2007
Last updated
07/08/2007
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