Individual
DR. MICHELLE NIXON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
EDD, LCMHC
Contact information
Practice address
32 W WINCHESTER ST STE 101, SALT LAKE CITY, UT 84107-5609
(801) 263-6367
Mailing address
PO BOX 735, ESCALANTE, UT 84726-0140
(435) 669-5399
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
7569606-6004
UT
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1760695837
—
UT
Enumeration date
05/07/2007
Last updated
12/30/2019
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