Nelson, Tiesha Simona
Nelson, Tiesha Simona is an individual health care provider with primary practice located at 8360 W Oakland Park Blvd Ste 303 , Sunrise FL 33351-7339. She recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Forensic, Behavioral Health & Social Service Providers / Psychologist. Behavioral Health & Social Service Providers / Psychologist is her primary health care specialty. Nelson, Tiesha Simona can be contacted via phone (954) 546-4677.Contact Information
Primary practice address
8360 W Oakland Park Blvd Ste 303
Sunrise FL 33351-7339
Phone: (954) 546-4677
Fax: (941) 328-3575
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 103TA0400X | PY7781 | Florida |
Behavioral Health & Social Service Providers / Clinical | 103TC0700X | PY7781 | Florida |
Behavioral Health & Social Service Providers / Forensic | 103TF0200X | PY7781 | Florida |
Behavioral Health & Social Service Providers / Psychologist | 103T00000X | PY 7781 | Florida |
Profile Details
NPI number | 1548407919 |
---|---|
LBN Legal business name | Nelson, Tiesha Simona |
Credentials | PSY.D. |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jan 7th, 2009 |
Last updated | Jan 6th, 2022 - about 2 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1548407919 | NPPES |
Florida | MEDICAID | 106660500 |
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