Healthcare Provider Details

I. General information

NPI: 1306538046
Provider Name (Legal Business Name): NICOLE VOBORA ACMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2023
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 E 400 S
BOUNTIFUL UT
84010-4919
US

IV. Provider business mailing address

1027 N HERTFORD LOOP
KAYSVILLE UT
84037-1399
US

V. Phone/Fax

Practice location:
  • Phone: 435-922-0271
  • Fax:
Mailing address:
  • Phone: 801-707-6224
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number12839030-6009
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: