Individual
MARY JACLYN NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ST
Contact information
Practice address
440 E TAMPA ST, SPRINGFIELD, MO 65806-1131
(417) 831-0150
(417) 865-3479
Mailing address
631 N FOREST AVE, SPRINGFIELD, MO 65802-4504
(417) 207-2580
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2013017730
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2013017730
MISSOURI LICENSE
MO
Enumeration date
04/11/2019
Last updated
06/11/2019
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us