Provider Demographics
NPI:1154665685
Name:WILLIAMS-JONES, DEANTE MARTRAL
Entity Type:Individual
Prefix:
First Name:DEANTE
Middle Name:MARTRAL
Last Name:WILLIAMS-JONES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3744 BIRCHDALE CT
Mailing Address - Street 2:
Mailing Address - City:N LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89032-7627
Mailing Address - Country:US
Mailing Address - Phone:702-463-0110
Mailing Address - Fax:702-463-0166
Practice Address - Street 1:3744 BIRCHDALE CT
Practice Address - Street 2:
Practice Address - City:N LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032-7627
Practice Address - Country:US
Practice Address - Phone:702-463-0110
Practice Address - Fax:702-463-0166
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-21
Last Update Date:2012-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst