Provider Demographics
NPI:1023238078
Name:NELSON, TERI LYNN (CB-MT)
Entity type:Individual
Prefix:MRS
First Name:TERI
Middle Name:LYNN
Last Name:NELSON
Suffix:
Gender:F
Credentials:CB-MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 KELVINGROVE DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-6245
Mailing Address - Country:US
Mailing Address - Phone:256-721-2224
Mailing Address - Fax:
Practice Address - Street 1:118 KELVINGROVE DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-6245
Practice Address - Country:US
Practice Address - Phone:256-721-2224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist