Provider Demographics
NPI:1679821813
Name:NELSON, MARGARET ANNETTE (DR MARGARET NELSON)
Entity Type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:ANNETTE
Last Name:NELSON
Suffix:
Gender:F
Credentials:DR MARGARET NELSON
Other - Prefix:
Other - First Name:MARGARET
Other - Middle Name:
Other - Last Name:NELSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2389 G.F GRIFFIN ROAD
Mailing Address - Street 2:
Mailing Address - City:BARTOW
Mailing Address - State:FL
Mailing Address - Zip Code:33830
Mailing Address - Country:US
Mailing Address - Phone:863-701-5428
Mailing Address - Fax:
Practice Address - Street 1:2389 E.F GRIFFIN ROAD
Practice Address - Street 2:
Practice Address - City:BARTOW
Practice Address - State:FL
Practice Address - Zip Code:33830
Practice Address - Country:US
Practice Address - Phone:863-701-5428
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-20
Last Update Date:2012-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLLCMFT0351010512106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist