Individual
LORI NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
22 N 1ST ST, NEWARK, OH 43055-5608
(740) 334-4056
Mailing address
445 E DUBLIN GRANVILLE RD, WORTHINGTON, OH 43085-3192
(614) 844-3800
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2615030
—
OH
Enumeration date
03/25/2022
Last updated
03/25/2022
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