Provider Demographics
NPI:1366730913
Name:VAIL, JONI SUE
Entity type:Individual
Prefix:
First Name:JONI
Middle Name:SUE
Last Name:VAIL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:677 E ROSE LN
Mailing Address - Street 2:
Mailing Address - City:ENOCH
Mailing Address - State:UT
Mailing Address - Zip Code:84721-9435
Mailing Address - Country:US
Mailing Address - Phone:435-531-1269
Mailing Address - Fax:
Practice Address - Street 1:170 E ALTAMIRA DR
Practice Address - Street 2:
Practice Address - City:CEDAR CITY
Practice Address - State:UT
Practice Address - Zip Code:84720-3509
Practice Address - Country:US
Practice Address - Phone:435-586-0213
Practice Address - Fax:435-865-9428
Is Sole Proprietor?:No
Enumeration Date:2011-07-18
Last Update Date:2011-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker