Individual
AMY NIELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CMHC
Contact information
Practice address
4562 N OREGON TRL, ENOCH, UT 84721-7450
(435) 590-4417
Mailing address
4562 N OREGON TRL, ENOCH, UT 84721-7450
(435) 590-4417
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
4989889-6004
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4989889-6004
DIVISION OF OCCUPATIONAL & PROFESSIONAL LICENSING
UT
Enumeration date
05/21/2007
Last updated
01/18/2013
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