Provider Demographics
NPI:1629561782
Name:JONES, KRISTA BELVILLE (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KRISTA
Middle Name:BELVILLE
Last Name:JONES
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:KRISTA
Other - Middle Name:BELVILLE
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5805 STATE BRIDGE RD # G-328
Mailing Address - Street 2:
Mailing Address - City:JOHNS CREEK
Mailing Address - State:GA
Mailing Address - Zip Code:30097-8220
Mailing Address - Country:US
Mailing Address - Phone:951-216-0090
Mailing Address - Fax:470-499-1116
Practice Address - Street 1:4855 RIVER GREEN PKWY STE 610
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-8337
Practice Address - Country:US
Practice Address - Phone:470-499-1116
Practice Address - Fax:866-321-1385
Is Sole Proprietor?:No
Enumeration Date:2018-06-12
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28462235Z00000X
GA012285235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist