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1679976443
TIMOTHY NELSON
DETROIT, MI
NPI
1679976443
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2014-10-07
Last Update Date
2014-10-07
Business Address
-- TIMOTHY NELSON
12684 SUSSEX ST
DETROIT, MI 48227-2116
Phone number: 313-471-0572
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Mailing Address
-- TIMOTHY NELSON
12684 SUSSEX ST
DETROIT, MI 48227-2116
Phone number: 313-471-0572
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