Provider Demographics
NPI:1699906099
Name:REINEN, JASEE JANAY (SSW)
Entity type:Individual
Prefix:
First Name:JASEE
Middle Name:JANAY
Last Name:REINEN
Suffix:
Gender:F
Credentials:SSW
Other - Prefix:
Other - First Name:JASEE
Other - Middle Name:JANAY
Other - Last Name:BURRELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:SSW
Mailing Address - Street 1:PO BOX 460
Mailing Address - Street 2:
Mailing Address - City:BOUNTIFUL
Mailing Address - State:UT
Mailing Address - Zip Code:84011-0460
Mailing Address - Country:US
Mailing Address - Phone:801-773-7060
Mailing Address - Fax:801-774-6100
Practice Address - Street 1:2250 N 1700 W
Practice Address - Street 2:
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041-1140
Practice Address - Country:US
Practice Address - Phone:801-773-7060
Practice Address - Fax:801-774-6100
Is Sole Proprietor?:No
Enumeration Date:2009-08-03
Last Update Date:2009-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6621787-3503104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker