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Individual

TIMOTHY J. NELSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
8950 W EMERALD ST STE 178, BOISE, ID 83704-8296
(208) 376-7083
Mailing address
8950 W EMERALD ST STE 178, BOISE, ID 83704-8296
(208) 376-7083

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LMSW-40082
ID

Other

Enumeration date
10/06/2020
Last updated
10/06/2020
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