Individual
NICOLE M BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1910 E SPRING LN, HOLLADAY, UT 84117-7023
(425) 273-0295
Mailing address
1910 E SPRING LN, HOLLADAY, UT 84117-7023
(425) 273-0295
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
9024027-3501
UT
Other
Enumeration date
01/06/2014
Last updated
11/02/2017
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