Individual
JOENE FARRIS NICOLAISEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6526 S STATE ST, 404, MURRAY, UT 84107-7261
(801) 313-6814
Mailing address
PO BOX 71279, SALT LAKE CITY, UT 84171-0279
(801) 313-6814
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5052659-6004
UT
Other
Enumeration date
09/13/2006
Last updated
07/08/2007
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