Provider Demographics
NPI:1558824516
Name:JONES, MARCELLA J (BAA)
Entity Type:Individual
Prefix:
First Name:MARCELLA
Middle Name:J
Last Name:JONES
Suffix:
Gender:F
Credentials:BAA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2253 RUSSELL ST
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-4217
Mailing Address - Country:US
Mailing Address - Phone:989-854-8811
Mailing Address - Fax:
Practice Address - Street 1:705 S DORT HWY
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48503-2852
Practice Address - Country:US
Practice Address - Phone:989-854-8811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-08
Last Update Date:2019-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker