Provider Demographics
NPI:1942474309
Name:PATTERSON, JERALYN(JERI) DONNA (MFT)
Entity type:Individual
Prefix:
First Name:JERALYN(JERI)
Middle Name:DONNA
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 E HORIZON DR
Mailing Address - Street 2:SUITE G
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89015-8035
Mailing Address - Country:US
Mailing Address - Phone:702-592-3369
Mailing Address - Fax:702-568-7554
Practice Address - Street 1:220 E HORIZON DR
Practice Address - Street 2:SUITE G
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89015-8035
Practice Address - Country:US
Practice Address - Phone:702-592-3369
Practice Address - Fax:702-568-7554
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-16
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0948106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist