Provider Demographics
NPI:1700010162
Name:JONES, MERRILY MASSEY (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:MERRILY
Middle Name:MASSEY
Last Name:JONES
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5308 OTTER CREEK CT
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-4126
Mailing Address - Country:US
Mailing Address - Phone:615-377-1630
Mailing Address - Fax:
Practice Address - Street 1:5308 OTTER CREEK CT
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-4126
Practice Address - Country:US
Practice Address - Phone:615-377-1630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-13
Last Update Date:2009-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN538235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist