Organization
PATHWAYS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA A NELSON (CREDENTIALING)
(906) 233-1236
Entity
Organization
Contact information
Practice address
200 W SPRING ST, MARQUETTE, MI 49855-4661
(906) 233-1236
Mailing address
200 W SPRING ST, MARQUETTE, MI 49855-4661
(906) 233-1236
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
02/25/2020
Last updated
02/25/2020
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