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Individual

PATRICIA NELSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ALC

Contact information

Practice address
1307 CHRISTINE AVE, ANNISTON, AL 36207-4661
(256) 235-3799
Mailing address
322 IRBY DR, EASTABOGA, AL 36260-5531
(256) 591-2748

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
C3184A
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
C3184A
AL
Enumeration date
08/06/2019
Last updated
08/06/2019
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