Individual
LARRY NELSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
301 S ALLEN ST, ALBANY, NY 12208-2070
(518) 489-7777
Mailing address
301 S ALLEN ST, ALBANY, NY 12208-2070
(518) 489-7777
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
20836
NY
Other
Enumeration date
12/17/2014
Last updated
12/17/2014
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