Provider Demographics
NPI:1972710531
Name:JONES, D EVELYN (LICENSED HEARING AID)
Entity Type:Individual
Prefix:MS
First Name:D
Middle Name:EVELYN
Last Name:JONES
Suffix:
Gender:F
Credentials:LICENSED HEARING AID
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2412 WEST STATE ST
Mailing Address - Street 2:
Mailing Address - City:ALLIANCE
Mailing Address - State:OH
Mailing Address - Zip Code:44601
Mailing Address - Country:US
Mailing Address - Phone:330-821-3277
Mailing Address - Fax:330-821-7760
Practice Address - Street 1:2412 WEST STATE ST
Practice Address - Street 2:
Practice Address - City:ALLIANCE
Practice Address - State:OH
Practice Address - Zip Code:44601
Practice Address - Country:US
Practice Address - Phone:330-821-3277
Practice Address - Fax:330-821-7760
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2198237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH41000000155223Medicaid