Provider Demographics
NPI:1518738426
Name:SLADE, JONAH DELEON (MFTI)
Entity Type:Individual
Prefix:
First Name:JONAH
Middle Name:DELEON
Last Name:SLADE
Suffix:
Gender:M
Credentials:MFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1503 COBBLESTONE LN
Mailing Address - Street 2:
Mailing Address - City:SAINT GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-8587
Mailing Address - Country:US
Mailing Address - Phone:435-231-2126
Mailing Address - Fax:
Practice Address - Street 1:736 S 900 E STE 203D
Practice Address - Street 2:
Practice Address - City:SAINT GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-7000
Practice Address - Country:US
Practice Address - Phone:385-777-6357
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-10
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist