Jennifer Anne Nibley Cannon, PH.D.
Individual provider Active NPI Clinical Psychologist · American Fork, UT
NPI 1104127869 · NPPES record last updated Apr 29, 2014
Key facts
- NPI
- 1104127869
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 7429787-2501 (UT)
- Practice address
- 796 E Pacific Dr Ste B
American Fork, UT 84003-3161 - Phone
- (801) 756-1626
- Fax
- (801) 756-1627
- NPI assigned
- Nov 11, 2010
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7429787-2501 | UT | MD | Clinical Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 7429787-2501 | UT | Yes |
Addresses
Primary practice location
796 E Pacific Dr Ste B
American Fork, UT 84003-3161
Mailing address
560 W 800 N
Orem, UT 84057-3746
Phone (801) 225-6246
Other providers in American Fork, UT
- Breanna Call
- Jacob Call
- William Brandon Callor
- Eva I Calvillo Chavira
- Jordana Campos Gutierrez
- Canyon Vista Psychiatry PLLC
- Molly Anne Capcha
- John K Capua
- Erica Card
- Jose Antonio Cardenas Troya
All providers in American Fork, UT · Clinical Psychologist in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 29, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.