Provider Demographics
NPI:1205017852
Name:JONES, ANGELA KAYE (LMT MLDT)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:KAYE
Last Name:JONES
Suffix:
Gender:F
Credentials:LMT MLDT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10023 OCEAN HWY # 17
Mailing Address - Street 2:
Mailing Address - City:PAWLEYS ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29585-7806
Mailing Address - Country:US
Mailing Address - Phone:843-902-7361
Mailing Address - Fax:
Practice Address - Street 1:10023 OCEAN HWY # 17
Practice Address - Street 2:
Practice Address - City:PAWLEYS ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29585-7806
Practice Address - Country:US
Practice Address - Phone:843-314-8002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-23
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1373172M00000X
SC7393103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No172M00000XOther Service ProvidersMechanotherapist