Individual
BLAIR NICOL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4007 S 1500 W, VERNAL, UT 84078-4665
(628) 222-9621
Mailing address
4263 W TWILIGHT DR, SALT LAKE CITY, UT 84118-4623
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
13020916-3501
UT
Other
Enumeration date
06/03/2026
Last updated
06/03/2026
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