Provider Demographics
NPI:1497904981
Name:JONES, CONNIE J (MS, CCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:CONNIE
Middle Name:J
Last Name:JONES
Suffix:
Gender:F
Credentials:MS, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:146 MIMOSA PT
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71913-7651
Mailing Address - Country:US
Mailing Address - Phone:501-844-7022
Mailing Address - Fax:501-262-5960
Practice Address - Street 1:146 MIMOSA PT
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-7651
Practice Address - Country:US
Practice Address - Phone:501-844-7022
Practice Address - Fax:501-262-5960
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-09
Last Update Date:2008-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR649235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
01101344OtherAMERICAN SPEECH-LANGUAGE-HEARING ASSOCIATION
AR649OtherARKANSAS BOARD OF EXAMINERS FOR SPEECH PATHOLOGY AND AUDIOLOGY
AR125647721Medicaid