Individual
NICOLE GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11631 S 700 E, DRAPER, UT 84020-8288
(801) 712-8907
Mailing address
11312 S BERG HOLLOW LN, SOUTH JORDAN, UT 84095-4023
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
14226749-4104
UT
Other
Enumeration date
11/22/2022
Last updated
12/08/2025
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