Nelson, Scott Bruce

Nelson, Scott Bruce is an sole proprietor health care provider with primary practice located at 855 W 8Th Ave , Mesa AZ 85210-3401. He recently has only one registered license in Behavioral Health & Social Service Providers / School, which is considered as his primary health care specialty. Nelson, Scott Bruce can be contacted via phone (480) 472-1039.

Contact Information

Primary practice address
855 W 8Th Ave Mesa AZ 85210-3401
Phone: (480) 472-1039
Fax: (480) 472-1110
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / School 103TS0200X 1632 Arizona

Profile Details

NPI number 1134268626
LBN Legal business name Nelson, Scott Bruce
Credentials PHD
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 5th, 2007
Last updated Jul 9th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134268626 NPPES
Arizona MEDICAID 788391

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