Individual
NICOLE LAVONNE MALSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
68 N 180 W, EPHRAIM, UT 84627-2130
(435) 283-9932
(435) 283-4920
Mailing address
68 N 180 W, EPHRAIM, UT 84627-2130
(435) 283-9932
(435) 283-4920
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
UT
Other
Enumeration date
11/20/2020
Last updated
11/20/2020
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