Individual
TASIA NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
135 WALPOLE LOOP, DAVENPORT, FL 33897-8021
(863) 667-6110
Mailing address
135 WALPOLE LOOP, DAVENPORT, FL 33897-8021
(863) 667-6110
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
09/27/2023
Last updated
09/27/2023
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