Individual
TARA D NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSAC
Contact information
Practice address
316 S MAIN ST, WOODSTOCK, VA 22664-1254
(540) 908-8585
Mailing address
316 S MAIN ST, WOODSTOCK, VA 22664-1254
(540) 325-7373
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0709024731
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0709024731
CSAC LICENSE
VA
Enumeration date
09/09/2022
Last updated
09/09/2022
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