Individual
MRS. ADRIENNE NIELSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6910 S HIGHLAND DR STE 1, COTTONWOOD HEIGHTS, UT 84121-3061
(801) 222-2222
Mailing address
1129 S 1000 E APT 3, PROVO, UT 84606-5078
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0409037070
—
UT
Enumeration date
10/30/2019
Last updated
10/30/2019
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