Individual
NICOLE FISHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SSW
Contact information
Practice address
750 NORTH 200 WEST, PROVO, UT 84601
(801) 373-4760
(801) 373-0639
Mailing address
750 NORTH 200 WEST, PROVO, UT 84601
(801) 373-4760
(801) 373-0639
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
333885-6009
UT
104100000X
Social Worker
333885 3503
UT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/31/2006
Last updated
10/15/2024
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