Provider Demographics
NPI:1205046695
Name:HUSKIE, NELDA D (LMSW)
Entity type:Individual
Prefix:MRS
First Name:NELDA
Middle Name:D
Last Name:HUSKIE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3881
Mailing Address - Street 2:
Mailing Address - City:TUBA CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86045-3881
Mailing Address - Country:US
Mailing Address - Phone:928-283-4753
Mailing Address - Fax:
Practice Address - Street 1:TUBA CITY REGIONAL HEALTH CARE CORPORATION
Practice Address - Street 2:167 NORTH MAIN STREET
Practice Address - City:TUBA CITY
Practice Address - State:AZ
Practice Address - Zip Code:86045-3881
Practice Address - Country:US
Practice Address - Phone:928-283-2831
Practice Address - Fax:928-283-2832
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2010-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLMSW-11386104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker