Individual
ROBIN NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
366 SW 5TH AVE, MERIDIAN, ID 83642-8600
(208) 898-9755
Mailing address
6599 DURANT LN, MERIDIAN, ID 83642-7133
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LCPC305
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010147314
REGENCE BLUE SHIELD
ID
01
—
Q5654
BLUE CROSS OF IDAHO
ID
Enumeration date
10/04/2007
Last updated
10/04/2007
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