Medina, Nicole I
Medina, Nicole I is an individual health care provider with primary practice located at 5965 S 900 E , Murray UT 84121-1757. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Psychologist. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Medina, Nicole I can be contacted via phone (801) 872-5516.Contact Information
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 10158726-2501 | Utah |
Behavioral Health & Social Service Providers / Psychologist | 103T00000X | 10158726-2501 | Utah |
Profile Details
NPI number | 1235488008 |
---|---|
LBN Legal business name | Medina, Nicole I |
Credentials | PSYD |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Sep 7th, 2012 |
Last updated | Aug 11th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1235488008 | NPPES |
Utah | Other | 10158726-2501 | PROFESSIONAL LICENSE |
Utah | MEDICAID | 1235488008 | PROFESSIONAL LICENSE |
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