Individual
ALICE NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
113 N ELM ST, CANBY, OR 97013-3519
(503) 657-8903
(503) 650-4302
Mailing address
113 N ELM ST, CANBY, OR 97013-3519
(503) 263-8903
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
T1234
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
T1234
LICENSED MARRIAGE AND FAMILY THERAPIST
OR
Enumeration date
10/30/2013
Last updated
02/28/2023
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