Individual
TIM MCNELIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
505 7TH AVE SW, FARIBAULT, MN 55021-5914
(507) 210-0141
Mailing address
505 7TH AVE SW, FARIBAULT, MN 55021-5914
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
FAMILY COUNSELING
—
Enumeration date
02/01/2020
Last updated
02/01/2020
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