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Individual

KENNETH JAMES NELAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MS

Contact information

Practice address
11514 N PORT WASHINGTON RD STE 101, MEQUON, WI 53092-3442
(414) 433-9193
(414) 433-9193
Mailing address
11514 N PORT WASHINGTON RD STE 101, MEQUON, WI 53092-3442
(414) 433-9193
(414) 433-9193

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
101YP1600X
Pastoral Counselor
101YP2500X
Professional Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100063661
WI
Enumeration date
04/25/2016
Last updated
03/14/2023
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