Individual
DAN'ELLE NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
20542 HARPER AVE, SUITE 109, HARPER WOODS, MI 48225-1693
(313) 571-3908
(313) 571-3909
Mailing address
18601 BAINBRIDGE DR, SOUTHFIELD, MI 48076-5312
(248) 792-7535
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6065003
MEDICARE (PTAN)
MI
Enumeration date
09/06/2012
Last updated
04/21/2013
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