Individual
JOHN-MIKE NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
L.P.C.
Contact information
Practice address
9228 GEORGE WASHINGTON MEMORIAL HWY, GLOUCESTER, VA 23061-4162
(804) 695-8119
(804) 695-8122
Mailing address
9228 GEORGE WASHINGTON MEMORIAL HWY, GLOUCESTER, VA 23061-4162
(804) 695-8119
(804) 695-8122
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701005173
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1497717615
—
VA
Enumeration date
02/09/2012
Last updated
02/09/2012
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