Individual
ERICA MARIE NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
650 S KOMAS DR, SALT LAKE CITY, UT 84108-1215
(801) 581-5515
Mailing address
2079 S 1200 E # S103, SALT LAKE CITY, UT 84105-3580
(763) 257-3131
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
09/06/2017
Last updated
09/06/2017
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