George (trey) Tanner Nicholson III
NPI #1033080445 in South Salt Lake, Utah
Provider Information
- NPI Number
- 1033080445
- Entity Type
- Individual
- Name
- George (trey) Tanner Nicholson III
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Counselor - Addiction (Substance Use Disorder)
- Enumeration Date
- Sep 17, 2025
- Last Updated
- Oct 24, 2025
Practice Location
- Address
- 177 W PRICE AVE
- City
- South Salt Lake
- State
- Utah
- ZIP Code
- 84115-4345
- Phone
- (385) 467-4548
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder) |
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| Ty Jensen, ASUDC | |
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Organizations
| Provider Name | |
|---|---|
| Axis-One INC |
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