Provider Demographics
NPI:1093989378
Name:JONES, MARY BETH (MS CCC SLP)
Entity Type:Individual
Prefix:
First Name:MARY BETH
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:MS CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5608 DEBLYN AVE
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-2606
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:808-242-4762
Practice Address - Street 1:5608 DEBLYN AVE
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-2606
Practice Address - Country:US
Practice Address - Phone:808-264-3825
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-17
Last Update Date:2018-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist