Individual
JANETTE NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISAC
Contact information
Practice address
151 RIVIERA DR STE B, LAKE HAVASU CITY, AZ 86403-5740
(928) 855-3432
Mailing address
1990 MCCULLOCH BLVD N STE D140, LAKE HAVASU CITY, AZ 86403-5749
(928) 486-2188
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
155301
AZ
Other
Enumeration date
03/01/2024
Last updated
04/03/2024
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