Doctor Name: | MR. JEFF MCINTYRE |
NPI Number: | 1679763775 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MS COUNSELOR, LPC |
License Number: | LPC-12648 |
Business Practice Address: | 32 N. 10th Ave Suite 200 Page, AZ - 860404884 |
Business Phone Number: | 9286600256 |
Business Fax Number: | |
Mailing Address: | Po Box 4884, PAGE |
State: | AZ |
Postal Code: | 860404884 |
Phone Number: | 9286600256 |
Fax Number: | |
NPI Enumeration Date: | 07/26/2007 |
NPI Last Update Date: | 07/16/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | LPC-12648 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |