Provider Demographics
NPI:1225260979
Name:REBER, JONETTE
Entity Type:Individual
Prefix:DR
First Name:JONETTE
Middle Name:
Last Name:REBER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2337 STONE CLIFF RD
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-6120
Mailing Address - Country:US
Mailing Address - Phone:435-674-7111
Mailing Address - Fax:435-673-9840
Practice Address - Street 1:2337 STONE CLIFF RD
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-6120
Practice Address - Country:US
Practice Address - Phone:435-674-7111
Practice Address - Fax:435-673-9840
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-13
Last Update Date:2009-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT86-148548-3902106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist