Provider Demographics
NPI:1780190173
Name:JONES, CINDY (CSUDC)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:CSUDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8661 W EDITH DR
Mailing Address - Street 2:
Mailing Address - City:MAGNA
Mailing Address - State:UT
Mailing Address - Zip Code:84044-1702
Mailing Address - Country:US
Mailing Address - Phone:801-803-1047
Mailing Address - Fax:
Practice Address - Street 1:8661 W EDITH DR
Practice Address - Street 2:
Practice Address - City:MAGNA
Practice Address - State:UT
Practice Address - Zip Code:84044-1702
Practice Address - Country:US
Practice Address - Phone:801-803-1047
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-20
Last Update Date:2017-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10486815-6018101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)