Individual
LISA MICHELLE NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
710 WAVERLY DR SE, ALBANY, OR 97322-5079
(541) 223-2847
Mailing address
2532 SANTIAM HWY SE # 114, ALBANY, OR 97322-5211
(541) 223-2847
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
ABA-B-10229384
OR
Other
Enumeration date
06/25/2021
Last updated
01/27/2023
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