Individual
MARK NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2220 AUSTIN AVE, WACO, TX 76701-1625
(254) 752-3451
Mailing address
PO BOX 890, WACO, TX 76703-0890
(254) 752-3451
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
13419
TX
Other
Enumeration date
02/10/2022
Last updated
02/10/2022
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