Provider Demographics
NPI:1073981684
Name:ROVEL-JONES, FALLON
Entity Type:Individual
Prefix:
First Name:FALLON
Middle Name:
Last Name:ROVEL-JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 M ST NW FL 5
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20037-1597
Mailing Address - Country:US
Mailing Address - Phone:202-677-6895
Mailing Address - Fax:202-741-3313
Practice Address - Street 1:2300 M ST NW FL 5
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-1597
Practice Address - Country:US
Practice Address - Phone:202-677-6895
Practice Address - Fax:202-741-3313
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-14
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC2255A2300X
MDA00009712255A2300X
FLAL41982255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer