Individual
MR. BRADLEY ROBERT NELSON
Active
Individual
MR. BRADLEY ROBERT NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MALP
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
103TB0200X
Cognitive & Behavioral Psychologist
Primary
LP0590
MN
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
121052100
—
MN
01
—
160767
UCARE
MN
01
—
3032501
PREFERRED ONE
MN
01
—
4K585NE
BCBS
MN
01
—
6275968
MEDICA
MN
01
—
97026
HEALTH PARTNERS
MN
Enumeration date
07/14/2006
Last updated
01/31/2024
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