Jeremy Nelson

NPI #1790087104 in Ada, Oklahoma

Provider Information

NPI Number: 1790087104
Entity Type: Individual
Name: Jeremy Nelson
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor - Mental Health
Enumeration Date: Nov 18, 2010
Last Updated: Nov 18, 2010

Practice Location

Address: 111 E 12TH ST
City: Ada
State: Oklahoma
ZIP Code: 74820-6501
Phone: (580) 436-2690

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Mental Health — Mental Health	101YM0800X	Primary

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