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1629293758
JERALD JEROME NELSON
MOORHEAD, MN
NPI
1629293758
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: MN 07373)
Enumeration Date
2007-04-16
Last Update Date
2007-07-08
Business Address
-- JERALD JEROME NELSON LICSW
2925 20TH ST S
MOORHEAD, MN 56560-5269
Phone number: 701-318-4292
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Mailing Address
-- JERALD JEROME NELSON LICSW
13299 WILDFLOWER LN
LAKE PARK, MN 56554-9132
Phone number: 701-318-4292
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