Provider Demographics
NPI:1568154607
Name:JONES, KENYA
Entity Type:Individual
Prefix:
First Name:KENYA
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3552 BOGGS RD
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:NC
Mailing Address - Zip Code:28610-9589
Mailing Address - Country:US
Mailing Address - Phone:910-280-0326
Mailing Address - Fax:
Practice Address - Street 1:1899 TATE BLVD SE # 2106
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-4200
Practice Address - Country:US
Practice Address - Phone:828-358-0976
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-25
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician