Individual
STEPHEN NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LLP
Contact information
Practice address
37450 SCHOOLCRAFT RD, LIVONIA, MI 48150-1082
(734) 713-0088
Mailing address
37450 SCHOOLCRAFT RD, LIVONIA, MI 48150-1082
(734) 713-0088
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301014464
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
750910681
BLUE CROSS
MI
Enumeration date
05/21/2010
Last updated
05/06/2016
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