Provider Demographics
NPI:1982903316
Name:JONES, NIKKI LEE
Entity Type:Individual
Prefix:MRS
First Name:NIKKI
Middle Name:LEE
Last Name:JONES
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 1:62 S 950 W
Mailing Address - Street 2:
Mailing Address - City:BRIGHAM CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84302-4424
Mailing Address - Country:US
Mailing Address - Phone:435-538-5063
Mailing Address - Fax:435-538-5065
Practice Address - Street 1:62 S 950 W
Practice Address - Street 2:
Practice Address - City:BRIGHAM CITY
Practice Address - State:UT
Practice Address - Zip Code:84302-4424
Practice Address - Country:US
Practice Address - Phone:435-538-5063
Practice Address - Fax:435-538-5065
Is Sole Proprietor?:No
Enumeration Date:2011-03-24
Last Update Date:2012-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor