Provider Demographics
NPI:1952648339
Name:NIBLEY, ERIN COLLEEN
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:COLLEEN
Last Name:NIBLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5226 S COBBLE CREEK RD APT 9F
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84117-6730
Mailing Address - Country:US
Mailing Address - Phone:206-305-2552
Mailing Address - Fax:253-697-3730
Practice Address - Street 1:5226 S COBBLE CREEK RD APT 9F
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84117-6730
Practice Address - Country:US
Practice Address - Phone:206-305-2552
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-06
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5172203-6004101YM0800X
WALH60761968101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health