Doctor Name: | MRS. DEANNA R NICHOLS |
NPI Number: | 1750649265 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCMHC, RDN |
License Number: | 278841-4901 |
Business Practice Address: | 11075 S State St Ste 14 Sandy, UT - 840705194 |
Business Phone Number: | 8015800552 |
Business Fax Number: | |
Mailing Address: | 1791 E Mule Deer Dr, DRAPER |
State: | UT |
Postal Code: | 840205625 |
Phone Number: | 8015800552 |
Fax Number: | |
NPI Enumeration Date: | 05/03/2012 |
NPI Last Update Date: | 03/16/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | 278841-4901 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | UT |
Taxonomy Type: | Dietary & Nutritional Service Providers |
Taxonomy Classification: | Dietitian, Registered |
Taxonomy Specialization: | |
Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |