Provider Demographics
NPI:1629232483
Name:JON UREY PHD PLLC
Entity Type:Organization
Organization Name:JON UREY PHD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JON
Authorized Official - Middle Name:
Authorized Official - Last Name:UREY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-763-9577
Mailing Address - Street 1:2608 RING RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-7945
Mailing Address - Country:US
Mailing Address - Phone:270-763-9577
Mailing Address - Fax:
Practice Address - Street 1:2608 RING RD
Practice Address - Street 2:SUITE 102
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-7945
Practice Address - Country:US
Practice Address - Phone:270-763-9577
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-10
Last Update Date:2008-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty