Provider Demographics
NPI:1780306563
Name:NIGRO, EVE NICHOLE (MA)
Entity type:Individual
Prefix:
First Name:EVE
Middle Name:NICHOLE
Last Name:NIGRO
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:EVE
Other - Middle Name:NICHOLE
Other - Last Name:BRAZNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:404 E 4500 S STE B22
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-2776
Mailing Address - Country:US
Mailing Address - Phone:801-268-1564
Mailing Address - Fax:801-268-1565
Practice Address - Street 1:404 E 4500 S
Practice Address - Street 2:STE B22
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-2776
Practice Address - Country:US
Practice Address - Phone:801-268-1564
Practice Address - Fax:801-268-1565
Is Sole Proprietor?:No
Enumeration Date:2022-09-16
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT13028634-6009101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health