| NPI | 1932547007 |
|---|---|
| Former Name | VICKI NELSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: KS 10065) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KS 067) |
| Enumeration Date | 2013-06-11 |
| Last Update Date | 2019-01-12 |