Provider Demographics
NPI:1518547397
Name:JONES, MICHELLE LENORE (RBT)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:LENORE
Last Name:JONES
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8092 W PARADISE LN APT 2107
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85382-4990
Mailing Address - Country:US
Mailing Address - Phone:603-213-4381
Mailing Address - Fax:
Practice Address - Street 1:8092 W PARADISE LN
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85382-4976
Practice Address - Country:US
Practice Address - Phone:603-213-4381
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-14
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHRBT-20-132670106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst