| Doctor Name: | NICOLE KATRINA KORMAN |
| NPI Number: | 1962794164 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | L.C.S.W., S.U.D.C. |
| License Number: | 6242266-6006 |
| Business Practice Address: | 7105 S Highland Dr Suite #101 Cottonwood Heights, UT - 841213753 |
| Business Phone Number: | 8017834779 |
| Business Fax Number: | |
| Mailing Address: | 7105 S Highland Dr, Suite # 101 COTTONWOOD HEIGHTS |
| State: | UT |
| Postal Code: | 841213753 |
| Phone Number: | 8017393754 |
| Fax Number: | |
| NPI Enumeration Date: | 05/05/2011 |
| NPI Last Update Date: | 02/28/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 6242266-6006 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | UT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |