Individual provider · Type 1 NPI

Russell Glenn Nelson

Addiction (Substance Use Disorder) Counselor · San Luis Obispo, CA

NPI number 1124298732 Active

Practice location

2180 Johnson Ave
San Luis Obispo, CA 93401-4513

Call (805) 788-2524 Map

Fax (805) 788-2056

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XNone listed

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1124298732

Russell Glenn Nelson's National Provider Identifier is 1124298732, issued on Mar 11, 2008. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in San Luis Obispo, CA. The record was last updated on Oct 3, 2013.