Individual
ADAM NISENSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4505 S WASATCH BLVD STE 290, SALT LAKE CITY, UT 84124-4204
(385) 695-5949
Mailing address
2521 S PARK ST, SALT LAKE CITY, UT 84106-1307
(713) 256-8033
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
10312526-3904
UT
Other
Enumeration date
04/17/2019
Last updated
04/17/2019
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