Provider Demographics
NPI:1710118831
Name:JONES, KELLY M (PHD)
Entity Type:Individual
Prefix:DR
First Name:KELLY
Middle Name:M
Last Name:JONES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 CEDAR ST STE 43
Mailing Address - Street 2:
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01801-6362
Mailing Address - Country:US
Mailing Address - Phone:413-687-4708
Mailing Address - Fax:
Practice Address - Street 1:8 CEDAR ST STE 43
Practice Address - Street 2:
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801-6362
Practice Address - Country:US
Practice Address - Phone:413-687-4708
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-06
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9404103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist