Provider Demographics
NPI:1083495899
Name:JONES, GODDESS ZENA (HM, AMM-DD)
Entity Type:Individual
Prefix:DR
First Name:GODDESS ZENA
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:HM, AMM-DD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1055 W 27TH AVE APT 205
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-2455
Mailing Address - Country:US
Mailing Address - Phone:907-416-8218
Mailing Address - Fax:
Practice Address - Street 1:1055 W 27TH AVE APT 205
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-2455
Practice Address - Country:US
Practice Address - Phone:907-416-8218
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-09
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA544761-281424101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral