MEDICARE: WILLIAM NASON M.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	6301003841	MI

General Provider Information

NPI Number	:	1851513378
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM NASON M.S.

Provider Business Mailing Address
First Line	:	5207 WISHING WELL DR
Second Line	:
City	:	GRAND BLANC
State	:	MI
Zip	:	48439-4373
Country	:	US
Telephone Number	:	810-695-4015
Fax Number	:

Provider Business Practice Location Address
First Line	:	5207 WISHING WELL DR
Second Line	:
City	:	GRAND BLANC
State	:	MI
Zip	:	48439-4373
Country	:	US
Telephone Number	:	586-263-8700
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/03/2007
Last Update Date	:	07/28/2015

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