Provider Demographics
NPI:1508131681
Name:NELSON, NAOMI DAWN (PHD)
Entity Type:Individual
Prefix:DR
First Name:NAOMI
Middle Name:DAWN
Last Name:NELSON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2128 COLQUITT ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77098-3311
Mailing Address - Country:US
Mailing Address - Phone:713-523-6375
Mailing Address - Fax:
Practice Address - Street 1:2128 COLQUITT ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77098-3311
Practice Address - Country:US
Practice Address - Phone:713-523-6375
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-21
Last Update Date:2012-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24261103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist