Individual
NICOLE HANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CSW
Contact information
Practice address
5770 S 1500 W, TAYLORSVILLE, UT 84123-5216
(801) 313-7966
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
48497553502
UT
1041C0700X
Clinical Social Worker
Primary
4849755-3501
UT
Other
Enumeration date
04/16/2020
Last updated
07/15/2022
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