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Individual

MS. DESTINY AUTUMN NELSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1410 BLACK ST, PAHRUMP, NV 89060-3911
(702) 366-4771
Mailing address
1410 BLACK ST, PAHRUMP, NV 89060-3911
(702) 366-4771

Taxonomy

Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary

Other

Enumeration date
01/12/2012
Last updated
01/12/2012
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