Individual
JACOB CHRISTIAN NILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CSW
Contact information
Practice address
3590 HARRISON BLVD STE GL2, OGDEN, UT 84403-2060
(801) 644-8229
Mailing address
3590 HARRISON BLVD STE GL2, OGDEN, UT 84403-2060
(801) 644-8229
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
13580941-3502
UT
Other
Enumeration date
09/28/2023
Last updated
09/28/2023
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