Individual
MRS. LAURA B NILSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
EDS
Contact information
Practice address
4745 SUTTON PARK CT, SUITE 802, JACKSONVILLE, FL 32224-0250
(904) 476-5916
Mailing address
2172 BRIGHTON BAY TRL W, JACKSONVILLE, FL 32246-7205
(904) 476-5916
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
SS848
FL
Other
Enumeration date
05/25/2013
Last updated
05/25/2013
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