Provider Demographics
NPI:1174943971
Name:DOW-NELSON, PATRICE (PHD)
Entity type:Individual
Prefix:DR
First Name:PATRICE
Middle Name:
Last Name:DOW-NELSON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 ELIZABETH AVE
Mailing Address - Street 2:
Mailing Address - City:ISELIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08830-2144
Mailing Address - Country:US
Mailing Address - Phone:908-420-3932
Mailing Address - Fax:
Practice Address - Street 1:100 ELIZABETH AVE
Practice Address - Street 2:
Practice Address - City:ISELIN
Practice Address - State:NJ
Practice Address - Zip Code:08830-2144
Practice Address - Country:US
Practice Address - Phone:908-420-3932
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-18
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ5280103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical