Provider Demographics
NPI:1326429366
Name:JONES, AMY (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1875 LAWRENCE BROTHERS RD
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:38606-7483
Mailing Address - Country:US
Mailing Address - Phone:662-934-3588
Mailing Address - Fax:
Practice Address - Street 1:1875 LAWRENCE BROTHERS RD
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:MS
Practice Address - Zip Code:38606-7483
Practice Address - Country:US
Practice Address - Phone:662-934-3588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-16
Last Update Date:2015-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSS3805235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist