Provider Demographics
NPI:1689888521
Name:JONES, TANYA ARLENE (MS IECE)
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:ARLENE
Last Name:JONES
Suffix:
Gender:F
Credentials:MS IECE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4340 MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42001-4930
Mailing Address - Country:US
Mailing Address - Phone:270-442-7352
Mailing Address - Fax:270-441-7614
Practice Address - Street 1:4340 MEADOW LN
Practice Address - Street 2:
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42001-4930
Practice Address - Country:US
Practice Address - Phone:270-442-7352
Practice Address - Fax:270-441-7614
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist