Dylan Tyler Nelson, BA
Individual provider Active NPI Counselor · Tyrone, PA
NPI 1609135334 · NPPES record last updated May 15, 2012
Key facts
- NPI
- 1609135334
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- Practice address
- 453 Ferndale Dr
Tyrone, PA 16686-6709 - Phone
- (814) 215-9836
- NPI assigned
- May 15, 2012
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Bachelor of Arts
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Yes |
Addresses
Primary practice location
453 Ferndale Dr
Tyrone, PA 16686-6709
Mailing address
453 Ferndale Dr
Tyrone, PA 16686-6709
Phone (816) 215-9836
Other providers in Tyrone, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 15, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.