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General NPI Number Information
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NPI Number | 1942443163
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Entity Type | Individual
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Provider Name | JEFFREY JOHN RICE M ED
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Gender | Male
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Dates
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Enumeration Date | 04/17/2009
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Last Update Date | 05/27/2010
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Provider Practice Location Address
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Address Line | 711 N BEAVER ST
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City | FLAGSTAFF
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State | AZ
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Zip | 86001-3103
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Country | US
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Telephone | 928-607-1276
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Fax |
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Provider Business Mailing Address
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Address Line | 4065 S NICHOLAS ST
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City | FLAGSTAFF
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State | AZ
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Zip | 86001-6919
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Country | US
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Telephone | 928-607-1276
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 13160
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License Number State | AZ
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