Individual
CHRISTIE NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
130 E WALNUT ST, SUITE 706, GREEN BAY, WI 54301-4239
(920) 437-8256
(920) 437-1188
Mailing address
PO BOX 19070, GREEN BAY, WI 54307-9070
(920) 496-4700
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2105
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39151200
—
WI
Enumeration date
01/16/2007
Last updated
10/06/2017
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