Individual
IAN NELSON-JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
6649 ODANA RD, MADISON, WI 53719-1011
(847) 736-2917
Mailing address
6649 ODANA RD, MADISON, WI 53719-1011
(847) 736-2917
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
103TC0700X
Clinical Psychologist
Primary
092237
IA
Other
Enumeration date
12/16/2016
Last updated
04/26/2023
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