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NPI Code Detail

MEDICARE: MRS. JONELLE F. ORD M.ED., LPC

MEDICARE: MRS. JONELLE F. ORD M.ED., LPC
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
1101YP2500XProfessional Counselor6557940-6004UT

General Provider Information

NPI Number : 1972724649
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JONELLE F. ORD M.ED., LPC
Provider Business Mailing Address
First Line : 724 E 2100 S
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84106-1830
Country : US
Telephone Number : 801-487-0499
Fax Number :
Provider Business Practice Location Address
First Line : 724 E 2100 S
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84106-1830
Country : US
Telephone Number : 801-487-0499
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2007
Last Update Date : 03/04/2013

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