Individual
DOROTHY DENISE NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
964 GATES AVE, KINGMAN, AZ 86401-4072
(928) 279-1662
Mailing address
964 GATES AVE, KINGMAN, AZ 86401-4072
(928) 279-1662
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW11873
AZ
Other
Enumeration date
09/29/2012
Last updated
09/29/2012
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