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General NPI Number Information
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NPI Number | 1811209745
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Entity Type | Individual
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Provider Name | RACHEL J. NELSON LPC
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Gender | Female
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Dates
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Enumeration Date | 07/08/2010
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Last Update Date | 02/04/2019
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Provider Practice Location Address
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Address Line | 310 MID CONTINENT PLZ STE 404
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City | WEST MEMPHIS
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State | AR
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Zip | 72301
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Country | US
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Telephone | 901-295-9422
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Fax |
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Provider Business Mailing Address
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Address Line | 706 CARTER DR
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City | MARION
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State | AR
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Zip | 72364-2403
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Country | US
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Telephone | 901-295-9422
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | P1202018
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License Number State | AR
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