Individual
MS. NICOLE WALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCMHC
Contact information
Practice address
1355 N MAIN ST, SUITE 1, BOUNTIFUL, UT 84010-5981
(801) 660-5233
(801) 295-4201
Mailing address
1355 NORTH MAIN STREET, SUITE 1, BOUNTIFUL, UT 84010
(801) 660-5233
(801) 295-4201
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
8180027-6004
UT
Other
Enumeration date
01/13/2015
Last updated
01/13/2015
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