Provider Demographics
NPI:1366772279
Name:COX, JOHN DONALD
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:DONALD
Last Name:COX
Suffix:
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 1:2501 TRIPP DR
Mailing Address - Street 2:APARTMENT #2
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89512-4074
Mailing Address - Country:US
Mailing Address - Phone:774-622-9391
Mailing Address - Fax:
Practice Address - Street 1:738 PRATER WAY
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89431-4466
Practice Address - Country:US
Practice Address - Phone:775-356-0371
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-28
Last Update Date:2009-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV5381-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical