Individual
SIMON DANIEL NICOLIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSWI
Contact information
Practice address
873 BAXTER DR, SOUTH JORDAN, UT 84095-8506
(801) 548-1347
Mailing address
P.O BOX 708458, SANDY, UT 84070
(801) 548-1347
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
5990693-3506
UT
Other
Enumeration date
08/02/2011
Last updated
08/02/2011
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