Provider Demographics
NPI:1760626840
Name:JONES, TAISHA M (PHD)
Entity Type:Individual
Prefix:
First Name:TAISHA
Middle Name:M
Last Name:JONES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:TAISHA
Other - Middle Name:M
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:305 S PALM ST
Mailing Address - Street 2:ARKANSAS STATE HOSPITAL
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-5432
Mailing Address - Country:US
Mailing Address - Phone:501-686-9016
Mailing Address - Fax:
Practice Address - Street 1:305 S. PALM STREET
Practice Address - Street 2:ARKANSAS STATE HOSPITAL
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205
Practice Address - Country:US
Practice Address - Phone:501-686-9016
Practice Address - Fax:501-686-9648
Is Sole Proprietor?:No
Enumeration Date:2009-04-21
Last Update Date:2013-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist