Individual
MRS. JOANN A NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
316 2ND AVE W, WILLISTON, ND 58801
(701) 774-4600
(701) 774-4620
Mailing address
PO BOX 463, TIOGA, ND 58852
(701) 755-3488
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2174
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0021762
BC/BS
—
05
—
54516
—
ND
Enumeration date
08/30/2006
Last updated
07/08/2007
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