| Doctor Name: | MR. DOUG E NIELSEN |
| NPI Number: | 1003034240 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MSW, LCSW |
| License Number: | 266439-3501 |
| Business Practice Address: | 1466 N Highway 89 Ste 220 Farmington, UT - 840252738 |
| Business Phone Number: | 8014510475 |
| Business Fax Number: | |
| Mailing Address: | Po Box 1219, EDEN |
| State: | UT |
| Postal Code: | 843101219 |
| Phone Number: | 8017453233 |
| Fax Number: | |
| NPI Enumeration Date: | 04/23/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 266439-3501 |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | UT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |