| Doctor Name: | ATHENA MARVIDIKIS |
| NPI Number: | 1003980681 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN |
| License Number: | 2244893102 |
| Business Practice Address: | 575 East 100 South Price, UT - 84501 |
| Business Phone Number: | 4356372358 |
| Business Fax Number: | 4356379141 |
| Mailing Address: | Po Box 867, PRICE |
| State: | UT |
| Postal Code: | 84501 |
| Phone Number: | 4356377200 |
| Fax Number: | 4356372377 |
| NPI Enumeration Date: | 11/17/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP0808X |
| License Number: | 2244893102 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | UT |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |