MEDICARE: RENEE JEFFERS

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	101Y00000X	Counselor

General Provider Information

NPI Number	:	1891185997
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RENEE JEFFERS

Provider Business Mailing Address
First Line	:	1524 PINYON AVE
Second Line	:
City	:	GRAND JUNCTION
State	:	CO
Zip	:	81501-8530
Country	:	US
Telephone Number	:	970-549-4325
Fax Number	:

Provider Business Practice Location Address
First Line	:	1524 PINYON AVE
Second Line	:
City	:	GRAND JUNCTION
State	:	CO
Zip	:	81501-8530
Country	:	US
Telephone Number	:	970-549-4325
Fax Number	:

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

Provider Enumeration Date	:	01/27/2015
Last Update Date	:	01/27/2015

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Directions to “ RENEE JEFFERS ” Practice Location

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