Most Relevant Information
Provider Data
| NPI Number: | 1003197567 |
| Provider Name: | DENNIS NELSON BS, LADC |
| Entity Type: | Individual |
| Taxonomy Code: | 101YA0400X |
| Specialty: | Counselor |
| License Number: | 300740 |
Most Important Dates
| Enumeration Date: | 08/29/2011 |
| Last Updated: | 08/29/2011 |
Provider Practice Location
2330 SIOUX TRL NW
PRIOR LAKE
MN
553729077
Practice Location Phone/Fax
| Phone: | 9524966164 |
| Fax: |
Provider Mailing Location
2330 SIOUX TRL NW
PRIOR LAKE
MN
553729077
Provider Mailing Phone/Fax
| Phone: | 9524966164 |
| Fax: |