Individual
CAROL LYNN NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
8767 SEMINOLE TRL STE 201C, RUCKERSVILLE, VA 22968-3494
(239) 405-1249
Mailing address
8767 SEMINOLE TRL STE 201C, RUCKERSVILLE, VA 22968-3494
(239) 405-1249
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904009918
VA
1041C0700X
Clinical Social Worker
SW9895
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1881914786
—
FL
Enumeration date
06/03/2010
Last updated
10/09/2017
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