Provider Demographics
NPI:1245359447
Name:JONES, LORRAINNE (SPEECH LANGUAGE PATH)
Entity type:Individual
Prefix:DR
First Name:LORRAINNE
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:SPEECH LANGUAGE PATH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13611 WATERFALL WAY
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33624
Mailing Address - Country:US
Mailing Address - Phone:813-964-8481
Mailing Address - Fax:813-964-8431
Practice Address - Street 1:16546 N. DALE MABRY HWY
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618
Practice Address - Country:US
Practice Address - Phone:813-964-8481
Practice Address - Fax:813-964-8431
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2016-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA2319235Z00000X
FL1-12-11483103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL880112600Medicaid
FL1-12-11483OtherBOARD ANALYST CERTIFICATION BOARD