Provider Demographics
NPI:1477827939
Name:NARANJO, JODIE L (APC)
Entity Type:Individual
Prefix:MS
First Name:JODIE
Middle Name:L
Last Name:NARANJO
Suffix:
Gender:F
Credentials:APC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:370 S 500 E
Mailing Address - Street 2:#135
Mailing Address - City:CLEARFIELD
Mailing Address - State:UT
Mailing Address - Zip Code:84015-4057
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:370 S 500 E
Practice Address - Street 2:#135
Practice Address - City:CLEARFIELD
Practice Address - State:UT
Practice Address - Zip Code:84015-4057
Practice Address - Country:US
Practice Address - Phone:804-941-9138
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-01
Last Update Date:2012-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT309316-6009101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health