Individual
CELESTE NICKLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
216 E MAIN ST STE 4, LEHI, UT 84043-2233
(801) 255-5131
Mailing address
216 E MAIN ST STE 4, LEHI, UT 84043-2233
(801) 255-5131
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
02/22/2021
Last updated
02/22/2021
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