Provider Demographics
NPI:1487629861
Name:JONES, GLORIA JEAN (PHD)
Entity Type:Individual
Prefix:
First Name:GLORIA
Middle Name:JEAN
Last Name:JONES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8339 E STONERIDGE ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67206-2331
Mailing Address - Country:US
Mailing Address - Phone:316-201-1177
Mailing Address - Fax:
Practice Address - Street 1:8339 E STONERIDGE ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206-2331
Practice Address - Country:US
Practice Address - Phone:316-201-1177
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-21
Last Update Date:2010-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS738103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS043066OtherBLUE CROSS BLUE SHIELD
KS1647OtherPREFERRED HEALTH SYSTEMS
KS043066OtherBLUE CROSS BLUE SHIELD