Individual
MS. LISA NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1000 W BROADWAY ST, OVIEDO, FL 32765-9260
(407) 359-5693
(407) 792-5693
Mailing address
150 S END ST, SAINT AUGUSTINE, FL 32095-6819
(702) 994-6049
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
06/19/2018
Last updated
06/19/2018
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