Individual
TERESA NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
665 HIGHWAY 51 STE D, RIDGELAND, MS 39157-2136
(601) 707-5023
(601) 707-5068
Mailing address
665 HIGHWAY 51 STE D, RIDGELAND, MS 39157-2136
(601) 707-5023
(601) 707-5068
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C0790
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02651769
—
MS
Enumeration date
09/28/2006
Last updated
02/02/2011
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