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General NPI Number Information
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NPI Number | 1235471004
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Entity Type | Individual
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Provider Name | AMBER L NELSON PSYD
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Gender | Female
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Dates
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Enumeration Date | 03/20/2013
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Last Update Date | 08/01/2024
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Provider Practice Location Address
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Address Line | 414 N MERIDIAN ST
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City | NEWBERG
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State | OR
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Zip | 97132-2697
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Country | US
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Telephone | 503-538-3838
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Fax |
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Provider Business Mailing Address
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Address Line | 414 N MERIDIAN ST V323
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City | NEWBERG
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State | OR
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Zip | 97132-2697
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Country | US
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Telephone | 541-892-2813
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | 3648
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License Number State | OR
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