Individual
KELLY M NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
11708 WAYZATA BLVD, MINNETONKA, MN 55305-2014
(952) 544-0964
(952) 544-6405
Mailing address
4519 QUAIL AVE N, ROBBINSDALE, MN 55422-1134
(763) 222-6383
(952) 544-6405
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
19801
MN
Other
Enumeration date
03/26/2012
Last updated
03/26/2012
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