Individual
MICHAEL NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2102 W BETHANY HOME RD, PHOENIX, AZ 85015-1935
(602) 774-4745
Mailing address
21 N FRASER DR, MESA, AZ 85203-8805
(520) 360-9594
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
AZ
1041C0700X
Clinical Social Worker
—
AZ
Other
Enumeration date
10/13/2018
Last updated
10/13/2018
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