Individual
TAUSHA NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
2055 GARRETT WAY STE 1, POCATELLO, ID 83201-5155
(208) 236-1600
Mailing address
2055 GARRETT WAY STE 1, POCATELLO, ID 83201-5155
(208) 236-1600
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
30233
ID
Other
Enumeration date
02/04/2010
Last updated
02/04/2010
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