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Individual

MARI CHRISTINA NELSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCPC, ICADC, DBTC

Contact information

Practice address
488 BLUE LAKES BLVD. NORTH, SUITE #108, TWIN FALLS, ID 83301
(208) 421-4293
Mailing address
488 BLUE LAKES BLVD N, SUITE #108, TWIN FALLS, ID 83301-4800
(208) 421-4293

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1133008
ID
101YM0800X
Mental Health Counselor
Primary
LCPC-6017
ID

Other

Enumeration date
10/08/2009
Last updated
03/23/2016
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