| Doctor Name: | MR. DAVID MICHAEL NICHOLS |
| NPI Number: | 1073830352 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 195 E 840 S Orem, UT - 840585016 |
| Business Phone Number: | 8012267696 |
| Business Fax Number: | 8012257053 |
| Mailing Address: | 1451 Cornerstone Dr, SOUTH JORDAN |
| State: | UT |
| Postal Code: | 840954533 |
| Phone Number: | 8016161499 |
| Fax Number: | |
| NPI Enumeration Date: | 04/27/2010 |
| NPI Last Update Date: | 04/27/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |