Provider Demographics
NPI:1396217444
Name:JONES, MOLLY MORGAN (BCBA)
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:MORGAN
Last Name:JONES
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2110 MOON STATION DR NW
Mailing Address - Street 2:
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30144-2759
Mailing Address - Country:US
Mailing Address - Phone:478-737-2038
Mailing Address - Fax:678-550-9396
Practice Address - Street 1:2110 MOON STATION DR NW
Practice Address - Street 2:
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30144-2759
Practice Address - Country:US
Practice Address - Phone:770-627-2267
Practice Address - Fax:678-550-9396
Is Sole Proprietor?:No
Enumeration Date:2018-12-28
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1-23-66517OtherBCBA