Individual
MR. NICHOLAS IAN MATHIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ACMHC
Contact information
Practice address
327 W GORDON AVE STE 1, LAYTON, UT 84041-2381
(801) 683-1062
Mailing address
1022 HENDERSON DR, OGDEN, UT 84404-5131
(801) 739-5894
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
280269-6009
UT
106S00000X
Behavior Technician
—
—
Other
Enumeration date
04/03/2018
Last updated
04/30/2020
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