MEDICARE: DR. JONETTE REBER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	86-148548-3902	UT

General Provider Information

NPI Number	:	1225260979
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JONETTE REBER

Provider Business Mailing Address
First Line	:	2337 STONE CLIFF RD
Second Line	:
City	:	ST GEORGE
State	:	UT
Zip	:	84790-6120
Country	:	US
Telephone Number	:	435-674-7111
Fax Number	:	435-673-9840

Provider Business Practice Location Address
First Line	:	2337 STONE CLIFF RD
Second Line	:
City	:	ST GEORGE
State	:	UT
Zip	:	84790-6120
Country	:	US
Telephone Number	:	435-674-7111
Fax Number	:	435-673-9840

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/13/2009
Last Update Date	:	08/13/2009

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