Organization
NIVATI INC
Active
Other names
Incorporate Massage
Organization subpart
No
Provider details
NPI number
Authorized official
AMELIA WILCOX (CEO)
(801) 891-3192
Entity
Organization
Contact information
Practice address
10808 S RIVER FRONT PKWY STE 3054, SOUTH JORDAN, UT 84095-5759
(800) 556-2950
Mailing address
10808 S RIVER FRONT PKWY STE 3054, SOUTH JORDAN, UT 84095-5759
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
—
—
225700000X
Massage Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
NA
UT
Enumeration date
07/18/2019
Last updated
09/28/2022
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