Individual
SHANICE NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
116 LARCH ST, SCRANTON, PA 18509-2802
(570) 489-5563
Mailing address
3023 MCCARTHY ST, SCRANTON, PA 18505-3010
(570) 780-0115
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
01/15/2025
Last updated
01/15/2025
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