Provider Demographics
NPI:1750657433
Name:JONES, RENAE (BCBA)
Entity Type:Individual
Prefix:MRS
First Name:RENAE
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1811 W KOCH ST
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-4127
Mailing Address - Country:US
Mailing Address - Phone:406-587-1181
Mailing Address - Fax:406-587-1801
Practice Address - Street 1:1811 W KOCH ST
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-4127
Practice Address - Country:US
Practice Address - Phone:406-587-1181
Practice Address - Fax:406-587-1801
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-28
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-117998103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst