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NPI Code Detail

MEDICARE: MRS. MISTIE JUBER

MEDICARE: MRS. MISTIE JUBER
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
1106S00000XBehavior TechnicianUT

General Provider Information

NPI Number : 1932830643
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MISTIE JUBER
Provider Business Mailing Address
First Line : 1305 N COMMERCE DR
Second Line :
City : SARATOGA SPRINGS
State : UT
Zip : 84045-5305
Country : US
Telephone Number : 385-557-7657
Fax Number :
Provider Business Practice Location Address
First Line : 1305 N COMMERCE DR
Second Line :
City : SARATOGA SPRINGS
State : UT
Zip : 84045-5305
Country : US
Telephone Number : 385-557-7657
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2022
Last Update Date : 06/22/2022

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Directions to “ MRS. MISTIE JUBER ” Practice Location

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