Individual
DIANA NICHOLSON-NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, MSW
Contact information
Practice address
1015 3RD ST NW, SALEM, OR 97304-4007
(503) 588-3600
Mailing address
1015 3RD ST NW, SALEM, OR 97304-4007
(503) 588-3600
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
6679
OR
1041C0700X
Clinical Social Worker
Primary
6679
OR
Other
Enumeration date
09/13/2018
Last updated
09/13/2018
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