Healthcare Provider Details

I. General information

NPI: 1609717347
Provider Name (Legal Business Name): CHOLANA NICHOLS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/06/2026
Last Update Date: 04/06/2026
Certification Date: 04/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

845 S 750 E APT B421
OREM UT
84097-7318
US

IV. Provider business mailing address

845 S 750 E APT B421
OREM UT
84097-7318
US

V. Phone/Fax

Practice location:
  • Phone: 435-224-4461
  • Fax:
Mailing address:
  • Phone: 435-224-4461
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number13937317-6004
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: