Individual
TERRY NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
401 BOGLE ST, SUITE 102, SOMERSET, KY 42503-3823
(606) 676-0638
Mailing address
401 BOGLE ST, SUITE 102, SOMERSET, KY 42503-3823
(606) 676-0638
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3421
KY
Other
Enumeration date
12/20/2013
Last updated
12/20/2013
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