Organization
RADIANT 828, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STORMEY NIELSEN LCSW (OWNER)
(385) 347-0904
Entity
Organization
Contact information
Practice address
5801 S FASHION BLVD STE 200, MURRAY, UT 84107-6162
(385) 347-0904
Mailing address
5801 S FASHION BLVD STE 200, MURRAY, UT 84107-6162
(385) 347-0904
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
05/01/2023
Last updated
05/01/2023
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