Individual
CONNIE NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
222 N KALAMAZOO MALL STE 100, KALAMAZOO, MI 49007
(269) 345-0273
Mailing address
7799 HARVEST LN, PORTAGE, MI 49002-9749
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6801085983
MI
Other
Enumeration date
10/23/2006
Last updated
12/26/2018
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