Provider Demographics
NPI:1063221521
Name:NIELSON, HANNAH WILSON (CMHC-I)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:WILSON
Last Name:NIELSON
Suffix:
Gender:F
Credentials:CMHC-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:962 E BLACK OAK DR
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:UT
Mailing Address - Zip Code:84780-1265
Mailing Address - Country:US
Mailing Address - Phone:801-935-1098
Mailing Address - Fax:
Practice Address - Street 1:85 N 300 W STE B
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:UT
Practice Address - Zip Code:84780-3563
Practice Address - Country:US
Practice Address - Phone:435-301-3129
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-30
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health