Provider Demographics
NPI:1760909113
Name:JONES, ANNE MARIE (MA, CCC-SPLIC)
Entity Type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:MARIE
Last Name:JONES
Suffix:
Gender:F
Credentials:MA, CCC-SPLIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 MAYFIELD ST
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29485-8417
Mailing Address - Country:US
Mailing Address - Phone:419-769-3336
Mailing Address - Fax:
Practice Address - Street 1:1325 BOONE HILL RD STE C
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29483-2490
Practice Address - Country:US
Practice Address - Phone:843-875-4161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-26
Last Update Date:2017-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3073235Z00000X
SC5232235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist