Provider Demographics
NPI:1871348433
Name:NELSON, ALESHA GRACE
Entity type:Individual
Prefix:
First Name:ALESHA
Middle Name:GRACE
Last Name:NELSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 E ROSE ST
Mailing Address - Street 2:
Mailing Address - City:ELK POINT
Mailing Address - State:SD
Mailing Address - Zip Code:57025-2231
Mailing Address - Country:US
Mailing Address - Phone:712-577-0662
Mailing Address - Fax:
Practice Address - Street 1:4700 GORDON DR STE 202
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51106-1911
Practice Address - Country:US
Practice Address - Phone:712-318-3351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-18
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health