Individual
TIMOTHY NELSON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
12684 SUSSEX ST, DETROIT, MI 48227-2116
(313) 471-0572
Mailing address
12684 SUSSEX ST, DETROIT, MI 48227-2116
(313) 471-0572
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
MI
Other
Enumeration date
10/07/2014
Last updated
10/07/2014
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