Provider Demographics
NPI:1417415878
Name:LAURA NELSON PLLC
Entity Type:Organization
Organization Name:LAURA NELSON PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:MA LPC
Authorized Official - Phone:806-789-4566
Mailing Address - Street 1:6010 W SPRING CREEK PKWY STE 231
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-3569
Mailing Address - Country:US
Mailing Address - Phone:806-789-4566
Mailing Address - Fax:
Practice Address - Street 1:6010 W SPRING CREEK PKWY STE 231
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-3569
Practice Address - Country:US
Practice Address - Phone:806-789-4566
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-05
Last Update Date:2019-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty