Individual
ERIKA NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ED.S.
Contact information
Practice address
110 FRANKS RD, MARENGO, IL 60152-3425
(815) 334-5869
Mailing address
110 FRANKS RD, MARENGO, IL 60152-3425
(815) 334-5869
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
920514
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
69515354
—
IL
Enumeration date
12/05/2017
Last updated
12/05/2017
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