Provider Demographics
NPI:1366638405
Name:NIELSEN, FLORENCE ANN (CSW)
Entity Type:Individual
Prefix:
First Name:FLORENCE
Middle Name:ANN
Last Name:NIELSEN
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1433 N 1075 W
Mailing Address - Street 2:STE 120
Mailing Address - City:FARMINGTON
Mailing Address - State:UT
Mailing Address - Zip Code:84025-2746
Mailing Address - Country:US
Mailing Address - Phone:801-520-0073
Mailing Address - Fax:801-447-9240
Practice Address - Street 1:1433 N 1075 W
Practice Address - Street 2:STE 120
Practice Address - City:FARMINGTON
Practice Address - State:UT
Practice Address - Zip Code:84025-2746
Practice Address - Country:US
Practice Address - Phone:801-520-0073
Practice Address - Fax:801-447-9240
Is Sole Proprietor?:No
Enumeration Date:2007-09-21
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT626833735021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical