Individual
MICHAEL JAN NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
420 1ST AVE S, WISCONSIN RAPIDS, WI 54495-4157
(715) 424-3400
(715) 424-3441
Mailing address
PO BOX 1535, WISCONSIN RAPIDS, WI 54495-1535
(715) 424-3400
(715) 424-3441
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1298-057
WI
Other
Enumeration date
10/16/2006
Last updated
07/21/2022
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