Individual
NICOLE SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2450 E FORT UNION BLVD, COTTONWOOD HEIGHTS, UT 84121-3337
(801) 669-5888
Mailing address
1003 W ROOFTOP DR, MIDVALE, UT 84047-4805
(703) 732-4531
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
10403016-3502
UT
Other
Enumeration date
09/01/2017
Last updated
03/17/2018
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