Provider Demographics
NPI:1013554005
Name:JONES, NIKKI (RBT)
Entity Type:Individual
Prefix:
First Name:NIKKI
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2637 MIDWAY BRANCH DR APT 204
Mailing Address - Street 2:
Mailing Address - City:ODENTON
Mailing Address - State:MD
Mailing Address - Zip Code:21113-4103
Mailing Address - Country:US
Mailing Address - Phone:410-908-9226
Mailing Address - Fax:
Practice Address - Street 1:2637 MIDWAY BRANCH DR APT 204
Practice Address - Street 2:
Practice Address - City:ODENTON
Practice Address - State:MD
Practice Address - Zip Code:21113-4103
Practice Address - Country:US
Practice Address - Phone:410-908-9226
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-09
Last Update Date:2019-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst