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Organization

COULEE REGION COUNSELING & CONSULTING

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JERRY A NELSON MS, LMFT (THERAPIST, / OWNER)
(608) 780-6685
Entity
Organization

Contact information

Practice address
W5073 COUNTY ROAD B, LA CROSSE, WI 54601-2983
(608) 780-6685
Mailing address
W5073 COUNTY ROAD B, LA CROSSE, WI 54601-2983
(608) 780-6685

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
713124
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
41000100
WI
Enumeration date
09/15/2008
Last updated
09/15/2008
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