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Individual

EMILY NELSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA, LAC

Contact information

Practice address
11747 N 19TH AVE, PHOENIX, AZ 85029-3590
(602) 613-0403
Mailing address
PSC 80 BOX 10964, APO, AP 96367-0012

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LAC-23762
AZ

Other

Enumeration date
12/19/2025
Last updated
02/09/2026
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