Individual
JACK NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
2219 LAUREL LN, ALLISON PARK, PA 15101-2103
(412) 486-0395
Mailing address
2219 LAUREL LN, ALLISON PARK, PA 15101-2103
(412) 486-0395
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS001530L
PA
Other
Enumeration date
04/28/2011
Last updated
04/28/2011
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