Provider Demographics
NPI:1154820991
Name:JONES, SHETEISHA (AP)
Entity Type:Individual
Prefix:
First Name:SHETEISHA
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 AIRLINE DR
Mailing Address - Street 2:
Mailing Address - City:BOSSIER CITY
Mailing Address - State:LA
Mailing Address - Zip Code:71111-2042
Mailing Address - Country:US
Mailing Address - Phone:318-588-5012
Mailing Address - Fax:318-588-5008
Practice Address - Street 1:4000 AIRLINE DR
Practice Address - Street 2:
Practice Address - City:BOSSIER CITY
Practice Address - State:LA
Practice Address - Zip Code:71111-2042
Practice Address - Country:US
Practice Address - Phone:318-588-5012
Practice Address - Fax:318-588-5008
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-07
Last Update Date:2018-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XM0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistMental Health