Provider Demographics
NPI:1285902452
Name:COX, DEIONE JEFFERY SR
Entity type:Individual
Prefix:MR
First Name:DEIONE
Middle Name:JEFFERY
Last Name:COX
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6430 ROCK SPARROW ST
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89084-2612
Mailing Address - Country:US
Mailing Address - Phone:702-445-9495
Mailing Address - Fax:
Practice Address - Street 1:525 S 13TH ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89101-7203
Practice Address - Country:US
Practice Address - Phone:702-380-2889
Practice Address - Fax:702-380-2893
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-02
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health