Provider Demographics
NPI:1063040772
Name:JONES TELEPRACTICE AGENCY
Entity Type:Organization
Organization Name:JONES TELEPRACTICE AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:910-705-7768
Mailing Address - Street 1:8416 GARNET CV
Mailing Address - Street 2:
Mailing Address - City:SHERWOOD
Mailing Address - State:AR
Mailing Address - Zip Code:72120-2387
Mailing Address - Country:US
Mailing Address - Phone:910-705-7768
Mailing Address - Fax:679-737-1047
Practice Address - Street 1:8416 GARNET CV
Practice Address - Street 2:
Practice Address - City:SHERWOOD
Practice Address - State:AR
Practice Address - Zip Code:72120-2387
Practice Address - Country:US
Practice Address - Phone:910-705-7768
Practice Address - Fax:679-737-1047
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-29
Last Update Date:2020-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty