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General NPI Number Information
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NPI Number | 1265394837
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Entity Type | Individual
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Provider Name | HAVEN NICHOLE NELSON
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Gender | Female
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Dates
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Enumeration Date | 12/02/2025
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 6700 E SPEEDWAY BLVD STE 401
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City | TUCSON
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State | AZ
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Zip | 85710-1220
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Country | US
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Telephone | 520-448-9005
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Fax |
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Provider Business Mailing Address
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Address Line | 1150 N DOWNING ST APT 301
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City | DENVER
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State | CO
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Zip | 80218-2956
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Country | US
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Telephone | 720-666-9152
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | 232318655215
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License Number State | CO
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