Provider Demographics
NPI:1255696423
Name:WINKEL-REEVE, MARNI K (MA, LMFT, ATR-BC)
Entity type:Individual
Prefix:
First Name:MARNI
Middle Name:K
Last Name:WINKEL-REEVE
Suffix:
Gender:F
Credentials:MA, LMFT, ATR-BC
Other - Prefix:
Other - First Name:MARNI
Other - Middle Name:K
Other - Last Name:WINKEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA LMFT, ATR-BC
Mailing Address - Street 1:1212 OLD WILLOW LN
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84604-3649
Mailing Address - Country:US
Mailing Address - Phone:801-850-8673
Mailing Address - Fax:
Practice Address - Street 1:37 E CENTER ST
Practice Address - Street 2:SUITE #208
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84606-3156
Practice Address - Country:US
Practice Address - Phone:801-224-8255
Practice Address - Fax:801-224-8301
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-12
Last Update Date:2013-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7349851-3902106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist