Penelope Ivy Nelson, LADC

NPI #1710640032 in Winnebago, Minnesota

Provider Information

NPI Number: 1710640032
Entity Type: Individual
Name: Penelope Ivy Nelson, LADC
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Counselor - Addiction (Substance Use Disorder)
Credential: LADC
Enumeration Date: Oct 14, 2021
Last Updated: Oct 14, 2021

Practice Location

Address: 132 1ST AVE SE
City: Winnebago
State: Minnesota
ZIP Code: 56098-1052
Phone: (612) 877-0276

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder)	101YA0400X	Primary

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